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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.

Last updated: Jul 17, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Actigraphy-derived sleep patterns in children and adolescents with persistent post-concussion symptoms: An exploratory study.

observational

Cassimatis M, Orr R, Ahmadi M, Browne G · JSAMS plus (2026)

Participants: N/A
Duration: 4 weeks (with follow-up until recovery)
Intervention: Observation of sleep patterns via wrist actigraphy and Insomnia Severity Index (ISI) classification
Outcome: Recovery time (days), sleep parameters (total sleep time, sleep latency, wake after sleep onset, sleep efficiency), mood disturbance
Effect Size: N/A (reported median recovery time difference: 150 vs 47 days, P=0.04)
Population: Children and adolescents aged 11-18 years with persistent post-concussion symptoms (n=20) presenting to a tertiary referral clinic

Result:

PubMed: 42434197DOI: 10.1016/j.jsampl.2026.100146

Mechanism Graph

Concussion leads to persistent post-concussion symptoms in 35% of children and adolescents
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Sleep disturbance (PCCI) occurs in a subset of these patients (45%)
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Mood disturbance exacerbates sleep disturbance over time
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Result: Prolonged recovery time in those with PCCI

Limitations

  • ⚠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).

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.