{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:44:14Z","timestamp":1792395854099,"version":"4.4.0"},"reference-count":73,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep\u2013wake disturbances (SWD) are frequent and persistent complications following pediatric traumatic brain injury (TBI), negatively affecting cognitive, emotional, and academic outcomes. This systematic review and meta\u2010analysis aimed to evaluate the effectiveness of behavioral, pharmacological, and emerging interventions for SWD in children and adolescents with mild to severe TBI and examined related sleep outcomes and functional measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Following PRISMA guidelines, a systematic search was conducted across PubMed, Web of Science, and ScienceDirect for studies published between 1998 and 2025. Nineteen studies (\n                      <jats:italic>N<\/jats:italic>\n                      = 1113) met inclusion criteria, encompassing cognitive behavioral therapy for insomnia (CBT\u2010I), sleep hygiene, mindfulness, pharmacological treatments (melatonin, branched\u2010chain amino acids), physical activity, and family\u2010based interventions. Meta\u2010analytic models using random effects were employed to calculate pooled standardized mean differences and mean raw scores across sleep, cognitive, and quality\u2010of\u2010life outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CBT\u2010I demonstrated efficacy in reducing persistent post\u2010concussion symptoms and improving subjective sleep outcomes, although heterogeneity varied across outcomes. In contrast, melatonin did not produce statistically significant pooled effects on persistent post\u2010concussion symptoms or cognitive outcomes, and treatment effects varied across dosage groups. Few studies examined mindfulness or educational outcomes, revealing key research gaps. Discrepancies between objective (actigraphy) and subjective (self\u2010report) measures emphasized the need for multi\u2010method sleep assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CBT\u2010I is the most consistently effective intervention for sleep problems following pediatric TBI. Melatonin showed mixed and nonsignificant pooled effects, indicating that its role in pediatric TBI recovery requires further investigation. Future research should focus on personalized, multidisciplinary treatment models integrating behavioral, pharmacological, and rehabilitative approaches to optimize long\u2010term neurocognitive and educational outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71556","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:59:51Z","timestamp":1790060391000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sleep\u2013Wake Disturbances in Pediatric Traumatic Brain Injury: A Systematic Review and Meta\u2010Analysis of Interventions"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5140-8399","authenticated-orcid":false,"given":"K.","family":"Lofitou","sequence":"first","affiliation":[{"name":"Center for Applied Neuroscience University of Cyprus  Nicosia Cyprus"},{"name":"Department of Psychology University of Cyprus  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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