Sleep Problems and Melatonin Prescription After Concussion Among Youth Athletes.

OBJECTIVES

To examine the effect of sleep disturbances on concussion symptom recovery and to examine the effect of melatonin prescription on symptom improvement among concussed adolescents with sleep problems.

DESIGN

Longitudinal test-retest.

SETTING

Sports medicine clinic.

PARTICIPANTS

Patients aged 8 to 18 years, diagnosed with a concussion, evaluated within 14 days after injury, and evaluated again 15 to 35 days after injury.

INDEPENDENT VARIABLES: We grouped patients based on whether they reported sleep disturbances within 14 days of injury.

MAIN OUTCOME MEASURES: Outcome measures included symptom severity, headache severity, melatonin prescription, and the change in symptom severity between visits.

RESULTS

Two hundred twenty-five patients were included: 36% who reported sleep problems (44% female; age = 14.4 ± 2.0 years; evaluated 7.3 ± 3.8 and 23.2 ± 5.4 days after injury) and 64% who did not (32% female; age = 14.6 ± 2.3 years; evaluated 7.2 ± 3.4 and 23.0 ± 5.3 days after injury). Those with sleep problems reported higher symptom severity than those without across the 2 visits (22.1 ± 14.3 vs 14.6 ± 12.5; P < 0.001). There was no significant difference in the change in symptom severity between visits among those who received [median = 9-point improvement; interquartile range (IQR) = 1-14] and did not (median = 9, IQR = 2-18) receive a melatonin prescription (P = 0.80).

CONCLUSIONS

Sleep problems among pediatric patients within 2 weeks of concussion are associated with more severe symptoms. Melatonin prescription was not associated with faster symptom recovery.