Abstract Details

Title Subjective and Objective Sleep Quality Independently Predict Persistent Post-concussion Symptoms

Topic Neuro Trauma and Critical Care

Presentation(s) S34 - Neuro Trauma and Sports Neurology (11:15 AM-11:27 AM)

Poster/Presentation
Number 001

Objective

This study investigates whether psychological and physiological factors, such as sleep, fear, anxiety, and resilience, serve as independent predictors of symptom burden in a cohort of subjects with significant persisting post-concussive symptoms (PPCS).

Background PPCS includes somatic, cognitive, and emotional symptoms lasting more than three months post injury, and can be influenced by a range of psychological and physiological factors. Previous studies have explored fear avoidance, catastrophizing, anxiety, and resilience as predictors of PPCS, yet other possible predictors such as sleep remain less well-studied in isolation and in the context of other known predictors.

Design/Methods Thirty participants with a high burden of PPCS (≥20 on the Rivermead Post Concussion Symptom Questionnaire (RPQ) ≥3 months post injury) were recruited into a clinical trial investigating the effects of neuromodulation on recovery. Leveraging baseline data from this trial, we analyzed first-order correlations to identify moderate-to-strong relationships (Pearson r≥0.4) between RPQ scores and demographic, injury-related, psychosocial, and both subjective and objective sleep variables. Sleep was assessed subjectively through participant-reported surveys and objectively over the course of one week using the Oura Ring, a wearable device that tracks sleep and physiological metrics. A multiple regression analysis of the top correlates was then conducted to determine significant independent predictors of PPCS (p<0.05).

Results Anxiety (Hospital Anxiety and Depression Scale, p=4.45 x 10^-5) and resilience (PROMIS Self-Efficacy for Managing Symptoms, p=0.027) independently predicted PPCS, aligning with current literature. Adding sleep metrics produced a model with anxiety (State-Trait Anxiety Inventory, p=0.002), objective sleep efficiency (Oura Average Sleep Efficiency, p=0.026) and subjective sleep impairment (PROMIS Sleep Impairment, p=0.037), explaining 65% of the variance in post-concussion symptom burden (RPQ).

Conclusions Anxiety, sleep impairment, and resilience independently contribute to PPCS and may each be targeted through tailored interventions. Incorporating wearable physiological monitoring with post-injury assessment could further support personalized care.

Authors/Disclosures
Rida F. Ismail, BS PRESENTER	Miss Ismail has nothing to disclose.
Akshata Kapadne	Miss Kapadne has nothing to disclose.
Christopher Giza, MD, F�鶹��ýӳ�� (UCLA, Depts of Pediatrics and Neurosurgery)	Dr. Giza has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medical Network Speakers Bureau. Dr. Giza has stock in Highmark Interactive. The institution of Dr. Giza has received research support from UCLA: Brain Injury Research Center, Steve Tisch BrainSPORT Program, Easton Clinic for Brain Health. Dr. Giza has received publishing royalties from a publication relating to health care. Dr. Giza has a non-compensated relationship as a Advisory Board with Major League Soccer that is relevant to �鶹��ýӳ�� interests or activities. Dr. Giza has a non-compensated relationship as a Advisory Board with National Basketball Association that is relevant to �鶹��ýӳ�� interests or activities. Dr. Giza has a non-compensated relationship as a Consultant with United States Soccer Federation that is relevant to �鶹��ýӳ�� interests or activities. Dr. Giza has a non-compensated relationship as a Co-founder & Advisor with Symptomwise that is relevant to �鶹��ýӳ�� interests or activities.
Kevin Bickart, MD, PhD (UCLA)	Dr. Bickart has nothing to disclose.

�鶹��ýӳ��

�鶹��ýӳ��