Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 28:16:2257-2268.
doi: 10.2147/NSS.S497858. eCollection 2024.

Feasibility of at-Home Sleep Monitoring in Adolescents with and without Concussion

Catherine C Donahue  1   2 , Katherine L Smulligan  1   2 , Mathew J Wingerson  1   2 , Joshua R Kniss  1   2 , Stacey L Simon  3   4 , Julie C Wilson  1   2   4 , David R Howell  1   2
Affiliations

Feasibility of at-Home Sleep Monitoring in Adolescents with and without Concussion

Catherine C Donahue et al. Nat Sci Sleep. .

Abstract

Background: Poor sleep is associated with longer recovery following adolescent concussion, making the longitudinal assessment of sleep important for monitoring recovery and identifying sleep disruptions. An important consideration for successful monitoring of sleep following concussion is the feasibility and adherence of a given sleep monitoring tool when used in an at-home environment. Understanding the usability of different sleep monitoring tools is essential for determining their applicability for longitudinal assessment in an ecologically valid environment.

Purpose: The purpose of this study was to: (1) report on the adherence and feasibility of at-home sleep monitoring in adolescents following concussion, and (2) compare outcomes of subjective and wearable measures of sleep between adolescents with and without a concussion.

Patients and methods: Participants included adolescents within 21 days of a concussion and uninjured controls that participated in four separate, prospective and longitudinal investigations of sleep following concussion. Sleep data was measured with: (1) Dreem Headband; (2) Philips Actiwatch; (3) Fitbit; and (4) subjective sleep diary. Sleep data was collected nightly, and adherence was defined as percentage of nights the participant used the sleep-monitoring tool over the study duration. Independent t-tests and effect sizes were calculated for the following sleep data outcomes as measured by each of the monitoring tools: duration, efficiency, latency, wake after sleep onset.

Results: Sleep data for a total of 183 adolescents (104 with concussion, 79 uninjured controls) was assessed. Adherence rates across all devices ranged from 53% to 98%, with the subjective sleep diary showing the highest adherence rate for both groups (concussion: 91%, control: 94%). Across the four different monitoring tools, adolescents with a concussion demonstrated longer duration, latency, wake after sleep onset, and lower (worse) efficiency, with medium to large effect sizes.

Conclusion: The results indicate that at-home sleep monitoring is a feasible approach for tracking sleep in adolescents following concussion.

Keywords: adolescent; concussion; sleep assessment.

PubMed Disclaimer

Conflict of interest statement

DH has received research support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R03HD094560, R01HD108133), the National Institute of Neurological Disorders And Stroke (R01NS100952, R43NS108823), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (1R13AR080451), 59th Medical Wing Department of the Air Force, MINDSOURCE Brain Injury Network, the Tai Foundation, the Colorado Clinical and Translational Sciences Institute (UL1 TR002535‐05), and the Denver Broncos Foundation. JW reports grants from National Institutes of Health, during the conduct of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Average adherence rates for length of study participating for sleep monitoring tools, stratified by group.
Figure 2
Figure 2
Radar plots comparing sleep outcomes for Dreem headband A, Philips Actiwatch B, sleep diary C, and Fitbit D, between adolescents with (red) and without a concussion (blue). The outer edges correspond to higher values for the given metric. Higher values for sleep duration and efficiency indicate better sleep, whereas higher values for latency and wake after sleep onset indicate poorer sleep.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Buysse DJ. Sleep Health: can We Define It? Does It Matter? Sleep. 2014;37(1):9–17. doi:10.5665/sleep.3298 - DOI - PMC - PubMed
    1. Bramley H, Henson A, Lewis MM, Kong L, Stetter C, Silvis M. Sleep Disturbance Following Concussion Is a Risk Factor for a Prolonged Recovery. Clin Pediatr. 2017;56(14):1280–1285. doi:10.1177/0009922816681603 - DOI - PubMed
    1. Tham SW, Fales J, Palermo TM. Subjective and Objective Assessment of Sleep in Adolescents with Mild Traumatic Brain Injury. J Neurotrauma. 2015;32(11):847–852. doi:10.1089/neu.2014.3559 - DOI - PMC - PubMed
    1. Tham SW, Aaron R, Palermo TM. The Role of Sleep Deficiency in the Trajectory of Postconcussive Symptoms in Adolescents. Brain Inj. 2019;33(11):1413–1419. doi:10.1080/02699052.2019.1643921 - DOI - PMC - PubMed
    1. Murdaugh DL, Ono KE, Reisner A, Burns TG. Assessment of Sleep Quantity and Sleep Disturbances During Recovery From Sports-Related Concussion in Youth Athletes. Arch Phys Med Rehabil. 2018;99(5):960–966. doi:10.1016/j.apmr.2018.01.005 - DOI - PubMed

LinkOut - more resources