Skip to main content
    • Aa
    • Aa

Pediatric Sleep Difficulties after Moderate–Severe Traumatic Brain Injury

  • Ruth E. Sumpter (a1), Liam Dorris (a2), Thomas Kelly (a3) and Thomas M. McMillan (a1)

The objective of this study is to systematically investigate sleep following moderate–severe pediatric traumatic brain injury (TBI). School-aged children with moderate–severe TBI identified via hospital records were invited to participate, along with a school-age sibling. Subjective reports and objective actigraphy correlates of sleep were recorded: Children's Sleep Habits Questionnaire (CSHQ), Sleep Self-Report questionnaire (SSR), and 5-night actigraphy. TBI participants (n = 15) and their siblings (n = 15) participated. Significantly more sleep problems were parent-reported (CSHQ: p = 0.003; d = 1.57), self-reported (SSR: p = 0.003; d = 1.40), and actigraph-recorded in the TBI group (sleep efficiency: p = 0.003; d = 1.23; sleep latency: p = 0.018; d = 0.94). There was no evidence of circadian rhythm disorders, and daytime napping was not prevalent. Moderate–severe pediatric TBI was associated with sleep inefficiency in the form of sleep onset and maintenance problems. This preliminary study indicates that clinicians should be aware of sleep difficulties following pediatric TBI, and their potential associations with cognitive and behavioral problems in a group already at educational and psychosocial risk. (JINS, 2013, 19, 1–6)

Corresponding author
Correspondence and reprint requests to: Liam Dorris, Fraser of Allander Neurosciences Unit, Royal Hospital for Sick Children, Glasgow, Scotland, United Kingdom, G3 8SJ. E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

D.W. Beebe , L. Krivitzky , C.T. Wells , S.L. Wade , H.G. Taylor , K.O. Yeates (2007). “Brief report: Parental report of sleep behaviors following moderate or severe pediatric traumatic brain injury”. Journal of Pediatric Psychology, 32(7), 845850.

D. Beebe , D. Rose , R. Amin (2010). Attention, learning, and arousal of experimentally sleep-restricted adolescents in a simulated classroom. Journal of Adolescent Health, 47(5), 523525.

S. Blunden , D.W. Beebe (2006). The contribution of intermittent hypoxia, sleep debt and sleep disruption to daytime performance deficits in children: Consideration of respiratory and non-respiratory sleep disorders. Sleep Medicine Review, 10, 109118.

J.F. Dewald , A.M. Meijer , F.J. Oort , G.A. Kerkhof , S.M. Bogels (2010). The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep Medicine Reviews, 14, 179189.

L. Dorris , N. Scott , S. Zuberi , N. Gibson , C. Espie (2008). Sleep problems in children with neurological disorders. Developmental Neurorehabilitation, 11(2), 95114.

R. Goodman (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology & Psychiatry & Allied Disciplines, 38, 581586.

C.A. Hawley (2003). Reported problems and their resolution following mild, moderate and severe traumatic brain injury amongst children and adolescents in the UK. Brain Injury, 17(2), 105129.

B. Jennett (1998). Epidemiology of head injury. Archives of Disease in Childhood, 78(5), 403406.

Y. Kaufman , O. Tzischinsky , R. Epstein , A. Etzioni , P. Lavie , G. Pillar (2001). Long-term sleep disturbances in adolescents after minor head injury. Pediatric Neurology, 24, 129134.

A.S. Lewandowski , M. Toliver-Sokol , T.M. Palermo (2011). Evidence-based review of subjective pediatric sleep measures. Journal of Pediatric Psychology, 36(7), 780793.

L.J. Meltzer , H.E. Montgomery-Downs , S.P. Insana , C.M. Walsh (2012). Use of actigraphy for assessment in pediatric sleep research. Sleep Medicine Reviews, 16(5), 463475.

G. Milroy , L. Dorris , T.M. McMillan (2008). Sleep disturbances following mild traumatic brain injury. Journal of Pediatric Psychology, 33(3), 242247.

M.C. Ouellet , J. Savard , C.M. Morin (2004). Insomnia following traumatic brain injury: A review. Neurorehabilitation and Neural Repair, 18(4), 187198.

J.A. Owens , R. Maxim , C. Nobile , M. McGuinn , M. Sell (2000). Parental and self-report of sleep in children with attention-deficit/hyperactivity disorder. Archives of Pediatrics & Adolescent Medicine, 154, 549555.

J.L. Ponsford , C. Willmott , A. Rothwell , P. Cameron , G. Ayton , R. Nelms , C. Curran (1999). Cognitive and behavioral outcome following mild traumatic head injury in children. Journal of Head Trauma Rehabilitation, 14(4), 2537.

A. Sadeh (2011). The role and validity of actigraphy in sleep medicine: An update. Sleep Medicine Reviews, 15(4), 259267.

M. Sambuco , N. Brookes , S. Lah (2008). Paediatric traumatic brain injury: A review of siblings’ outcome. Brain Injury, 22(1), 717.

S.W. Tham , T.M. Palermo , M.S. Vavilala , J. Wang , K.M. Jaffe , T.D. Koepsell , F.P. Rivara (2012). The longitudinal course, risk factors, and impact of sleep disturbances in children with traumatic brain injury. Journal of Neurotrauma, 29, 154161.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 3
Total number of PDF views: 24 *
Loading metrics...

Abstract views

Total abstract views: 129 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th June 2017. This data will be updated every 24 hours.