Study finds youth with concussion may benefit from monitoring sleep and limiting daytime naps

(COLUMBUS, Ohio) – Researchers at Nationwide Children’s Hospital have found that when it comes to concussion recovery, sleep matters. In a study published today in British Journal of Sports Medicine, researchers found that limiting daytime sleep and getting approximately seven hours of sleep each night in the first week after a concussion may speed up recovery.

“Youth who sleep more during the day or who sleep too much or too little each day may be at risk for slower concussion symptom resolution,” said lead author Jingzhen Ginger Yang, PhD, MPH, principal investigator in the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s. “Good sleep hygiene, including limiting daytime sleep/naps and instead focusing on getting enough sleep at night, could help speed concussion recovery.”

This new study, conducted by experts in Nationwide Children’s Center for Injury Research and Policy, division of Sports Medicine, and Center for Biobehavioral Health, evaluated sleep quantity and quality in the first week after a concussion and explored the associations between sleep measures and concussion recovery in youth. 

While some research on pediatric concussion has relied on self-reported sleep duration, this study used a wearable device to objectively measure sleep quantity (time in bed, total sleep time, and daytime sleep) and quality (sleep efficiency, wake after sleep onset, and number of awakenings) during the first week post-injury among youth aged 11-17 years with a physician-diagnosed concussion. This method captures total sleep time rather than just time in bed, providing a more accurate measurement of sleep duration.

“We know sleep is an important part of concussion recovery, yet youth often experience sleep disturbances during this period,” said Amy Valasek, MD, MS, sports medicine physician at Nationwide Children's and co-author of the study. “This study showed that youth with concussion may benefit from monitoring sleep quality. Clinical trials are necessary to determine the optimal timing, duration, and quality of sleep that support concussion recovery among youth.”

The relationship between sleep quantity and post-concussion symptom score is bidirectional during the first week post-injury, highlighting the importance of objectively measured sleep in this area of research. “It is vital for clinicians to actively engage in counseling pediatric patients and provide guidance on appropriate sleep hygiene to aid in concussion recovery among youth,” said Dr. Valasek.

This study has several important clinical implications:

• The appropriate amount of total sleep time during the first week post-concussion, neither too much nor too little, could hasten timelines for recovery. 
• Pediatricians should promote good sleep hygiene among youth immediately after concussion, including limiting daytime sleep/naps to help speed recovery. 
• Youth with concussion may benefit from monitoring sleep quantity and quality acutely postinjury using a wearable device to aid in recovery. 
• Clinical trials are necessary to determine the optimal timing, duration, and quality of sleep that support concussion recovery among youth.

Families should collaborate with their child’s care team to develop a plan based on injury severity and recovery milestones.

The Center for Injury Research and Policy (CIRP) of the Abigail Wexner Research Institute at Nationwide Children’s Hospital works globally to reduce injury-related pediatric death and disabilities. With innovative research at its core, CIRP works to continually improve the scientific understanding of the epidemiology, biomechanics, prevention, acute treatment, and rehabilitation of injuries. CIRP serves as a pioneer by translating cutting edge injury research into education, policy, and advances in clinical care. For related injury prevention materials or to learn more about CIRP, visit www.injurycenter.org. Follow CIRP on X @CIRPatNCH.

About The Abigail Wexner Research Institute at Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2024-25 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit free-standing pediatric health care systems providing unique expertise in pediatric population health, behavioral health, genomics and health equity as the next frontiers in pediatric medicine, leading to best outcomes for the health of the whole child.  Integrated clinical and research programs are part of what allows Nationwide Children’s to advance its unique model of care. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s faculty train the next generation of pediatricians, scientists and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Healthfunded free-standing pediatric research facilities in the U.S., supporting basic, clinical, translational, behavioral and population health research. The AWRI is comprised of multidisciplinary Centers of Emphasis paired with advanced infrastructure supporting capabilities such as technology commercialization for discoveries; gene- and cell-based therapies; and genome sequencing and analysis. More information is available at NationwideChildrens.org/Research.