300 Section - Treatment of Post-Concussive Sleep Disturbances in Children and Adults: A Scoping Review

Objectives : A concussion is a type of brain injury caused by direct trauma or rapid movement of the head, resulting in temporary loss of normal brain function. Studies have shown that 25-50% of individuals who sustain a concussion develop a post-injury sleep disturbance. The presence of a sleep disturbance contributes prolonged recovery from concussion and poorer long-term outcomes. Thus, identifying effective treatments for post-concussive sleep disturbances is essential in reducing the incidence of persistent post-concussive symptoms. The objective of this scoping review is to provide a cohesive summary of existing literature that describes treatment options for post-concussive sleep disturbances in children and adults.

Design: A literature search was conducted in MEDLINE, Embase, CINAHL, Web of Science, and ProQuest Dissertations & Theses Global. Two reviewers screened titles and abstracts, then full text articles against the inclusion and exclusion criteria. Primary studies that analyzed at least one treatment for post-concussive sleep disturbances were included.

Results: Of the 3660 articles yielded from the search, 1332 duplicates were removed, and 2258 articles were excluded during title and abstract screening. Full text screening was completed on the remaining 70 articles, and 18 articles were included in the review. The most commonly studied interventions were psychotherapy (5/18), blue-light therapy (2/18), melatonin (2/18), and photobiomodulation (2/18). Other interventions included gabapentin, a sensory-motor audio visual intervention, interdisciplinary rehabilitation, hand self-shiatsu, music relaxation therapy, acoustic neuromodulation, and a lifestyle education program. The majority of studies included adult participants only (11/18).

Conclusion: This review summarizes a variety of potential treatment options for children and adults experiencing post-concussive sleep disturbances. More robust studies are needed to determine the effectiveness of each intervention before they can be incorporated into clinical practice guidelines.