{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:46:47Z","timestamp":1785246407641,"version":"3.55.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T00:00:00Z","timestamp":1548115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Child Neurol"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Our objective was to identify factors associated with trouble falling asleep postconcussion. Patients seen for care after sport-related concussion were assessed \u226410 days postinjury and were between 6 and 19 years of age. Outcomes included symptoms (Post-Concussion Symptom Scale), postural steadiness, missed school, and medical history. There were 261 patients (49% female; mean age=14.8\u00b12.5 years): 45% reported trouble falling asleep. A greater proportion of patients who reported trouble falling asleep missed \u22652 days of school (64% vs 49%; P = .02). Patients who reported trouble falling asleep endorsed more severe symptom severity than those who did not (median=38 vs 18; P &lt; .001). After covariate adjustment, confusion (aOR = 1.95, 95% CI = 1.131-3.375), missing \u22652 days of school (aOR = 4.52, 95% CI = 1.553-13.16), and noise sensitivity (aOR = 1.48, 95% CI = 1.1.042-2.010) were independently associated with trouble falling asleep. Sleep disturbances are associated with poorer clinical outcomes after concussion. Inclusion of sleep assessments may help to provide early therapeutic pathways for pediatric concussion patients.<\/jats:p>","DOI":"10.1177\/0883073818824000","type":"journal-article","created":{"date-parts":[[2019,1,23]],"date-time":"2019-01-23T18:18:14Z","timestamp":1548267494000},"page":"256-261","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Trouble Falling Asleep After Concussion Is Associated With Higher Symptom Burden Among Children and Adolescents"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2955-0191","authenticated-orcid":false,"given":"David R.","family":"Howell","sequence":"first","affiliation":[{"name":"Sports Medicine Center, Children\u2019s Hospital Colorado, Aurora, CO, USA"},{"name":"Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA"},{"name":"The Micheli Center for Sports Injury Prevention, Waltham, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie R.","family":"Oldham","sequence":"additional","affiliation":[{"name":"The Micheli Center for Sports Injury Prevention, Waltham, MA, USA"},{"name":"Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA"},{"name":"Division of Sports Medicine, Department of Orthopaedics, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna N.","family":"Brilliant","sequence":"additional","affiliation":[{"name":"The Micheli Center for Sports Injury Prevention, Waltham, MA, USA"},{"name":"Division of Sports Medicine, Department of Orthopaedics, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"William P.","family":"Meehan","sequence":"additional","affiliation":[{"name":"The Micheli Center for Sports Injury Prevention, Waltham, MA, USA"},{"name":"Division 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