A-49 Predictors of sleep quality among adolescents following concussion.

Abstract

Abstract Purpose To identify predictors of sleep quality following concussion in adolescents. Methods Ninety-four (47%-F) participants aged 11-17 (14.31±2.8) years within 7 days of injury were recruited from a specialty concussion clinic and emergency department. Participants completed demographics, mTBI and medical history, Adolescent Sleep-Wake Scale (ASWS), Concussion Clinical Profiles Screening (CP Screen), and Post-Concussion Symptom Scale (PCSS). Stepwise logistic regressions (LR) were used to identify predictors of ASWS scores. Results of the LR were used to create a probability test variable for receiver operating characteristic (ROC) curve analyses. Results Results of the LR for ASWS total sleep score were significant (p<.001) and accurately identified 83.1% of adolescents with sensitivity of 76.7% and specificity of 89.1%, with history of anxiety (Adj OR=9.52, 95%CI=1.71-52.63, p=.01) and CP Screen anxiety domain total score (Adj OR=1.92, 95% CI=1.41-2.61, p<.001) as significant predictors. ROC analysis of the combined probability test variable for total sleep score was significant with area under the curve (AUC)=.88 (95%CI=.80-.94, p<.001). Similar findings were supported for history of anxiety and CP Screen anxiety domain scores on individual sleep domain scores. Conclusions History of anxiety and higher CP Screen anxiety score were predictive of poor sleep among adolescents following concussion. Surprisingly, age, sex, mTBI and migraine history, as well as total higher symptoms burden were not associated with poor sleep following concussion. The findings suggest that clinicians should focus on interventions to reduce anxiety to enhance sleep among adolescents following concussion.