Predictors of Sleep Outcomes Following Mild Traumatic Brain Injury in Preschoolers: Subjective and Objective Assessment of Outcome.

OBJECTIVES: To investigate sleep and its predictors in preschoolers with mild traumatic brain injury (mTBI).

PARTICIPANTS AND PROCEDURE: The sample included 225 children, aged 18 to 60 months, divided into 3 groups: children with accidental mTBI (n = 85), children with orthopedic injury (n = 58), and typically developing children (n = 82). Retrospective reports of preinjury sleep and family functioning were obtained as part of a baseline assessment at the time of recruitment. Parental ratings of sleep problems were collected 6 months postinjury on the full sample, and actigraphy data were collected on a subset of children. Demographic, preinjury, and periinjury factors were examined as potential predictors of sleep outcomes.

RESULTS: No group differences were found in ratings of sleep problems or for nighttime sleep duration and sleep efficiency, as measured by actigraphy. Besides, preexisting sleep disturbances and brain injury resulting in alteration of consciousness were identified as predictors of poorer sleep in the mTBI group.

CONCLUSION: Although mTBI did not result in group-level sleep disturbances 6 months postinjury, the findings suggest that premorbid and injury-related factors place some children at risk for poorer sleep after mTBI. These factors should be documented so clinicians can intervene early.