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Determine the effect of moderate and severe traumatic brain injuries (TBI) on the sleep of school-aged children.A concurrent cohort-prospective design compared children aged 6–12 years who sustained moderate TBI (baseline n=56), severe TBI (n=53), or only orthopedic injuries (n=80). Retrospective parental report of pre-injury sleep was collected about 3 weeks post-injury. Post-injury assessments occurred prospectively a mean of 6, 12, and 48 months later.Growth curve analyses compared the groups over time. The moderate TBI group had worse pre-injury sleep than the other groups. The moderate TBI and orthopedic injury groups displayed a small decline in sleep problems from pre- to post-injury. Children with severe TBI displayed increased post-injury sleep problems.Children who sustain severe TBI are at elevated risk for post-injury sleep problems. Because sleep problems may result in daytime impairments and family distress, additional clinical and research attention is warranted.