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. 2016 Dec 1;39(12):2141-2147.
doi: 10.5665/sleep.6314.

Sleep Quantity and Quality during Acute Concussion: A Pilot Study

Adam C Raikes  1 , Sydney Y Schaefer  2
Affiliations

Sleep Quantity and Quality during Acute Concussion: A Pilot Study

Adam C Raikes et al. Sleep. .

Abstract

Study objectives: A number of subjective and objective studies provide compelling evidence of chronic post-concussion changes in sleep, yet very little is known about the acute effects of concussion on sleep quality and quantity. Therefore, the purpose of this prospective pilot study was to use actigraphy to examine the changes in sleep quality and quantity acutely following concussion at home rather than in a hospital or sleep laboratory.

Methods: Seventeen young adults (7 with acute concussion, 10 controls) were recruited for this study. All participants completed two 5-day testing sessions separated by 30 days from intake (controls) or day of injury (concussion). Participants wore actigraphs and kept a sleep journal. Sleep parameter outcomes included nighttime total sleep time (nTST), 24-h total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE). The coefficient of variation (CV) for each sleep parameter was computed for each session.

Results: nTST and TST CV was significantly greater in the concussion group. There is the additional indication that individuals with a concussion may require and obtain more sleep shortly after injury and subsequently have a shorter duration of sleep at 1 mo post-injury. This pattern was not seen in the measures of sleep quality (WASO, SE).

Conclusions: Individuals with a concussion demonstrated increased nighttime sleep duration variability. This increase persisted at 1 mo post-injury and may be associated with previously documented self-reports of poor sleep quality lasting months and years after a concussion. Additionally, this increase may predispose individuals to numerous negative health outcomes if left untreated.

Keywords: actigraph; concussion; sleep duration; sleep quality.

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Figures

Figure 1
Figure 1
A. 5-day average sleep duration (min) per group per session. B. 5-day average wake after sleep onset (min) per group per session. C. 5-day average sleep efficiency (%) per group per session. D. 5-day average 24-hour total sleep (min) per group per session. Boxplots show medians and whiskers represent 1.5× the interquartile range. No statistically significant differences were observed. Outliers indicated with asterisk. Group means indicated with diamond symbol.
Figure 2
Figure 2
Nighttime sleep duration in minutes. Individual participants are differentiated by shape. Individuals in the concussion group demonstrated increased night-to-night variability in sleep duration.
Figure 3
Figure 3
A. Coefficient of variation for nighttime sleep duration per group per session. B. Coefficient of variation for wake after sleep onset per group per session. C. Coefficient of variation for average sleep efficiency (%) per group per session. D. Coefficient of variation for 24-hour total sleep (min) per group per session. Boxplots show medians and whiskers represent 1.5× the interquartile range. Statistically significant differences were observed between groups for nighttime sleep duration (P = 0.03). Twenty-four-hour total sleep duration coefficient of variation demonstrated a trend toward greater variability in the concussed group (P = 0.08). Outliers indicated with asterisks. Group means indicated with diamond symbol.
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