SLEEP disturbances may play a crucial role in recovery after paediatric brain injury, according to new research examining outcomes following mild traumatic brain injury in children. The study suggests newly emerging sleep problems could increase behavioural difficulties during recovery.
Sleep Disturbances Following Paediatric Brain Injury
Sleep problems are increasingly recognised as an important factor affecting recovery after traumatic brain injury in adults. However, their prevalence and clinical impact among children following paediatric brain injury remain less well understood.
Researchers investigated sleep disturbances in children who experienced mild traumatic brain injury and compared them with two control groups. The aim was to determine whether sleep problems were more common after paediatric brain injury and whether these disturbances were associated with behavioural symptoms, cognitive performance, or structural brain changes.
Study Findings
The multisite cohort study analysed 573 children, including 191 children with mild traumatic brain injury, 191 typically developing children, and 191 children with orthopaedic injury controls. The mean age of children with mild traumatic brain injury was 12.03 years (SD 0.6), and 112 children (58.6%) were male.
Children with paediatric brain injury were more likely to develop new clinical sleep disturbances compared with controls. Newly emerging sleep problems occurred in 29 children with mTBI (15.2%), compared with 22 of 191 children (11.5%) in the typically developing group and 19 of 191 children (9.9%) in the orthopaedic injury group. Chronic sleep disturbances were also more frequent among children with paediatric brain injury, affecting 41 children (21.5%), compared with 25 children (13.1%) in each control group.
Total sleep disturbance scores were significantly elevated compared with the typically developing group (β, −0.27; 95% CI, −0.45 to −0.10) but not the orthopaedic injury group (β, −0.12; 95% CI, −0.29 to 0.05). Behavioural symptoms were also higher (β, −0.30; 95% CI, −0.45 to −0.16) and were closely associated with sleep disturbances.
Clinical Implications for Paediatric Brain Injury Recovery
The findings suggest that sleep disturbances may represent a modifiable risk factor during paediatric brain injury recovery. In particular, newly emerging sleep problems appear strongly linked to behavioural difficulties, highlighting sleep management as a potential early intervention strategy.
Although no significant associations were found between sleep disturbances and cognition or white matter microstructure, researchers noted differences in cortical structure between injury groups. Children in the orthopaedic injury group showed greater cortical thickness (β, 0.18; 95% CI, 0.06 to 0.30) and volume (β, 0.06; 95% CI, 0.01 to 0.11) than those with mild traumatic brain injury.
Clinicians may therefore benefit from routinely assessing sleep disturbances during paediatric brain injury recovery. Early identification and treatment of sleep problems could help reduce behavioural complications and improve long term outcomes.
Reference
Betz AK. Sleep disturbances and cognition, behavior, and brain structure in children with mTBI. JAMA Netw Open. 2026;9(3):e260229.
Featured image: Catherine Chin on Adobe Stock
