Good sleep hygiene plays crucial role in youth concussion recovery

Researchers at Nationwide Children's Hospital have found that when it comes to concussion recovery, sleep matters. In a study published today in British Journal of Sports Medicine, researchers found that limiting daytime sleep and getting approximately seven hours of sleep each night in the first week after a concussion may speed up recovery.

"Youth who sleep more during the day or who sleep too much or too little each day may be at risk for slower concussion symptom resolution," said lead author Jingzhen Ginger Yang, PhD, MPH, principal investigator in the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children's. "Good sleep hygiene, including limiting daytime sleep/naps and instead focusing on getting enough sleep at night, could help speed concussion recovery."

This new study, conducted by experts in Nationwide Children's Center for Injury Research andPolicy, division of Sports Medicine, and Center for Biobehavioral Health, evaluated sleep quantity and quality in the first week after a concussion and explored the associations between sleep measures and concussion recovery in youth. 

While some research on pediatric concussion has relied on self-reported sleep duration, this study used a wearable device to objectively measure sleep quantity (time in bed, total sleep time, and daytime sleep) and quality (sleep efficiency, wake after sleep onset, and number of awakenings) during the first week post-injury among youth aged 11-17 years with a physician-diagnosed concussion. This method captures total sleep time rather than just time in bed, providing a more accurate measurement of sleep duration.

We know sleep is an important part of concussion recovery, yet youth often experience sleep disturbances during this period. This study showed that youth with concussion may benefit from monitoring sleep quality. Clinical trials are necessary to determine the optimal timing, duration, and quality of sleep that support concussion recovery among youth."

Amy Valasek, MD, MS, sports medicine physician at Nationwide Children's and co-author of the study

The relationship between sleep quantity and post-concussion symptom score is bidirectional during the first week post-injury, highlighting the importance of objectively measured sleep in this area of research. "It is vital for clinicians to actively engage in counseling pediatric patients and provide guidance on appropriate sleep hygiene to aid in concussion recovery among youth," said Dr. Valasek.

This study has several important clinical implications:

• The appropriate amount of total sleep time during the first week post-concussion, neither too much nor too little, could hasten timelines for recovery. 
• Pediatricians should promote good sleep hygiene among youth immediately after concussion, including limiting daytime sleep/naps to help speed recovery. 
• Youth with concussion may benefit from monitoring sleep quantity and quality acutely postinjury using a wearable device to aid in recovery. 
• Clinical trials are necessary to determine the optimal timing, duration, and quality of sleep that support concussion recovery among youth.

Families should collaborate with their child's care team to develop a plan based on injury severity and recovery milestones.