The role of sleep deficiency in the trajectory of postconcussive symptoms in adolescents.

The study analysed 29 adolescents and is described by the authors as a pilot, so the findings need replication in a larger sample. Sleep was assessed after the concussion, so the study cannot show whether sleep problems were caused by the injury or were already present. There was no comparison group, so changes in sleep could have followed any injury or life event. The sample was 69% female, which is higher than usual concussion prevalence samples, so sex differences cannot be judged. Recovery events such as return to school were not measured, so their influence on sleep and symptoms is unknown. No treatment for insomnia was tested, so the paper cannot show that treating sleep improves concussion recovery. Some data were missing: questionnaire response was 89.7% at Week 2 and 86.2% at 3 months, and one participant's actigraphy data were unusable.

The supplied text lists research support from a non-U.S. government source, but does not give a separate conflict-of-interest statement.

Do not conclude that treating insomnia after concussion will reduce symptoms. This pilot found an association between early insomnia symptoms and later postconcussive symptoms, not a tested treatment effect, and watch-measured sleep duration and efficiency did not predict symptoms.