Journal of the International Neuropsychological Society

Brief Communication

Pediatric Sleep Difficulties after Moderate–Severe Traumatic Brain Injury

Ruth E. Sumptera1, Liam Dorrisa2 c1, Thomas Kellya3 and Thomas M. McMillana1

a1 Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom

a2 Fraser of Allander Neurosciences Unit, Royal Hospital for Sick Children, National Health Service Greater Glasgow and Clyde, Glasgow, Scotland, United Kingdom

a3 Regional Neuroscience Centre, Newcastle General Hospital, Newcastle & Tyne National Health Service Trust, Newcastle, England, United Kingdom


The objective of this study is to systematically investigate sleep following moderate–severe pediatric traumatic brain injury (TBI). School-aged children with moderate–severe TBI identified via hospital records were invited to participate, along with a school-age sibling. Subjective reports and objective actigraphy correlates of sleep were recorded: Children's Sleep Habits Questionnaire (CSHQ), Sleep Self-Report questionnaire (SSR), and 5-night actigraphy. TBI participants (n = 15) and their siblings (n = 15) participated. Significantly more sleep problems were parent-reported (CSHQ: p = 0.003; d = 1.57), self-reported (SSR: p = 0.003; d = 1.40), and actigraph-recorded in the TBI group (sleep efficiency: p = 0.003; d = 1.23; sleep latency: p = 0.018; d = 0.94). There was no evidence of circadian rhythm disorders, and daytime napping was not prevalent. Moderate–severe pediatric TBI was associated with sleep inefficiency in the form of sleep onset and maintenance problems. This preliminary study indicates that clinicians should be aware of sleep difficulties following pediatric TBI, and their potential associations with cognitive and behavioral problems in a group already at educational and psychosocial risk. (JINS, 2013, 19, 1–6)

(Received June 22 2012)

(Revised March 28 2013)

(Accepted March 28 2013)

(Online publication April 22 2013)


  • TBI;
  • Head injury;
  • Child;
  • Pediatric;
  • Dyssomnias;
  • Actigraphy


c1 Correspondence and reprint requests to: Liam Dorris, Fraser of Allander Neurosciences Unit, Royal Hospital for Sick Children, Glasgow, Scotland, United Kingdom, G3 8SJ. E-mail: