{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:03:40Z","timestamp":1784099020208,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016308","name":"Wuxi Health and Family Planning Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016308","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017837","name":"Wuxi Science and Technology Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017837","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"\n Introduction<\/jats:title>\n High-energy trauma is characterized by severe injuries, complex clinical conditions, and high mortality rates. Trauma exposure itself induces stress and excessive alertness, leading to sleep disturbances, which in turn exacerbate anxiety, depression, and the risk of post-traumatic stress disorder, while delaying natural recovery after trauma. However, screening for sleep disorders in hospitalized children with high-energy trauma remain insufficient. This study aimed to explore early post\u2011traumatic sleep status and its associations with related symptoms in children with high\u2011energy trauma using ecological momentary assessment (EMA).<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n A longitudinal observational design was adopted. Children with high\u2011energy trauma admitted to our hospital from July 1, 2024, to May 15, 2025 were recruited using convenience sampling. Sleep status and related symptoms were continuously monitored for the first five days post\u2011trauma. Data were analyzed using generalized estimating equations (GEE) and multivariate linear regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 69 patients were included in the final analysis. Pain was the most severe symptom, followed by anxiety, fear, and fatigue. GEE revealed that pain, anxiety, fear, and dizziness were significantly associated with sleep quality (\n P<\/jats:italic>\n &lt; 0.001,\n P<\/jats:italic>\n = 0.033,\n P<\/jats:italic>\n = 0.012,\n P<\/jats:italic>\n = 0.034); pain, itching, and numbness were significantly associated with reduced sleep efficiency (\n P<\/jats:italic>\n &lt; 0.001,\n P<\/jats:italic>\n = 0.003,\n P<\/jats:italic>\n = 0.004), whereas fatigue was significantly associated with improved sleep efficiency (\n P<\/jats:italic>\n = 0.032); pain and fear were significantly associated with nocturnal awakenings (\n P<\/jats:italic>\n &lt; 0.001,\n P<\/jats:italic>\n = 0.009). Moreover, symptoms were often inter\u2011related. Multivariate linear regression showed that factors affecting sleep quality included pain on day\u202f1 and day\u202f3 (\n P<\/jats:italic>\n = 0.001,\n P<\/jats:italic>\n = 0.018), fear on day\u202f4 (\n P<\/jats:italic>\n = 0.045), and fear and itching on day\u202f5 (\n P<\/jats:italic>\n = 0.011,\n P<\/jats:italic>\n = 0.017). Regarding sleep efficiency, the primary influencing factor were: pain on day 1 post-trauma (\n P<\/jats:italic>\n = 0.001), numbness at the affected site on day 2 (\n P<\/jats:italic>\n = 0.004), fear, pruritus, and numbness at the affected site on day 4 (\n P<\/jats:italic>\n = 0.034,\n P<\/jats:italic>\n &lt; 0.001,\n P<\/jats:italic>\n &lt; 0.001), and pruritus on day 5 (\n P<\/jats:italic>\n &lt; 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Children with high\u2011energy trauma exhibit certain sleep disturbances in the early post\u2011traumatic period, and the main factors influencing sleep change over time. Close attention should be paid to sleep disorders and their associated influencing factors, and appropriate interventions should be implemented.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2026.1754778","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:04:10Z","timestamp":1784095450000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The relationship between post-traumatic sleep and related symptoms in children with high-energy trauma: a study based on ecological momentary assessment"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaoyan","family":"Feng","sequence":"first","affiliation":[{"name":"Affiliated Children\u2019s Hospital of Jiangnan University , , , China","place":["Wuxi, Jiangsu"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelian","family":"Zhu","sequence":"additional","affiliation":[{"name":"Affiliated Children\u2019s Hospital of Jiangnan University , , , China","place":["Wuxi, Jiangsu"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Affiliated Children\u2019s Hospital of Jiangnan University , , , China","place":["Wuxi, Jiangsu"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Ding","sequence":"additional","affiliation":[{"name":"Affiliated Children\u2019s Hospital of Jiangnan University , , , China","place":["Wuxi, Jiangsu"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Wei","sequence":"additional","affiliation":[{"name":"Affiliated Children\u2019s Hospital of Jiangnan University , , , China","place":["Wuxi, Jiangsu"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijun","family":"Hui","sequence":"additional","affiliation":[{"name":"Affiliated Children\u2019s Hospital of Jiangnan University , , , China","place":["Wuxi, Jiangsu"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefang","family":"Wu","sequence":"additional","affiliation":[{"name":"Affiliated Children\u2019s Hospital of Jiangnan University , , , China","place":["Wuxi, Jiangsu"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.14744\/tjtes.2022.42347","article-title":"BIG Score is a strong predictor of mortality and morbidity for high-energy traumas in the pediatric intensive care unit","volume":"28","author":"K\u0131ht\u0131r","year":"2022","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"B2","first-page":"116","article-title":"Research progress on fixation treatment of high-energy tibiofibular fractures","volume":"8","author":"Zhu","year":"2016","journal-title":"Clin J Chin Med"},{"key":"B3","volume-title":"Analysis of Influencing Factors of Post-Traumatic 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