Post-concussion clinical insomnia is associated with prolonged recovery time in children and adolescents with persistent post-concussion symptoms
In a prospective longitudinal study of 20 children and adolescents with persistent post-concussion symptoms, 45% also had post-concussion clinical insomnia (PCCI). Recovery time was three times longer for those with PCCI (median 150 days) compared to those without (median 47 days), and mood disturbance significantly predicted sleep disturbance at 4-week follow-up.
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Post-concussion clinical insomnia is associated with prolonged recovery time in children and adolescents with persistent post-concussion symptoms The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Post-concussion clinical insomnia is associated with prolonged recovery time in children and adolescents with persistent post-concussion symptoms
This conclusion is most relevant to: Children and adolescents aged 11-18 years with persistent post-concussion symptoms (n=20) presenting to a tertiary referral clinic.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Actigraphy-derived sleep patterns in children and adolescents with persistent post-concussion symptoms: An exploratory study. (JSAMS plus, 2026) —
How It Works
The proposed biological pathway:
- ▸Concussion leads to persistent post-concussion symptoms in 35% of children and adolescents
- ▸Sleep disturbance (PCCI) occurs in a subset of these patients (45%)
- ▸Mood disturbance exacerbates sleep disturbance over time
- ▸Result: Prolonged recovery time in those with PCCI
Who Might Benefit
Evidence fit by population:
- ▸Children and adolescents aged 11-18 years with persistent post-concussion symptoms (n=20) presenting to a tertiary referral clinic
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Small sample size (n=20) limits generalizability
- ▸Observational design cannot establish causality between sleep disturbance and prolonged recovery
Frequently Asked Questions
What percentage of children with persistent post-concussion symptoms also have clinical insomnia?▼
45% of participants with PPCS also had post-concussion clinical insomnia (PCCI) as identified by the Insomnia Severity Index.
How much longer does recovery take for children with post-concussion insomnia?▼
Recovery time was three times greater for those with PCCI (median 150 days) compared to those without (median 47 days).
What sleep parameters were measured in this study?▼
Total sleep time (mean 452.1 min), sleep latency (mean 32.2 min), wake after sleep onset (mean 76.9 min), and sleep efficiency (mean 85.9%) were measured using wrist actigraphy over 14 days.
Was mood disturbance linked to sleep problems in this study?▼
Yes, mood disturbance was a significant predictor of sleep disturbance at the 4-week follow-up (P=0.01).
References
- 1.Cassimatis M, Orr R, Ahmadi M, Browne G. “Actigraphy-derived sleep patterns in children and adolescents with persistent post-concussion symptoms: An exploratory study..” JSAMS plus, 2026. PMID: 42434197 DOI: 10.1016/j.jsampl.2026.100146