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Advanced Neurology

ORIGINAL RESEARCH ARTICLE
Relationship between sleep outcomes and

lifestyle factors in young adults who sustained
traumatic brain injury in childhood

Edith Botchway-Commey 1,2,3 *, Celia Godfrey 1,2,3 , Christian L. Nicholas 1,4,5 ,
Vicki Anderson 1,2,3,4 , and Cathy Catroppa 1,2,3,4
1 Clinical Sciences, Murdoch Children’s Research Institute, Victoria, Australia
2 Department of Psychology, Royal Children’s Hospital, Victoria, Australia
3 Department of Paediatrics, University of Melbourne, Victoria, Australia
4 School of Psychological Sciences, University of Melbourne, Victoria, Australia
5 Institute for Breathing and Sleep, Austin Health, Victoria, Australia

Abstract

This study investigated the relationships between subjective and objective sleep
outcomes and lifestyle factors (i.e., nap duration, screentime, chronotype, use
of tobacco, alcohol, caffeine, and medications) in young adults who sustained
traumatic brain injury (TBI) in childhood. The study was conducted at the Murdoch
Children’s Research Institute and Royal Children’s Hospital (Australia). It reports
cross-sectional data collected at 20 years post-childhood TBI, as part of a prospective
study. Participants included 54 young adults with TBI (mean age, 27.7; standard
*Corresponding author: deviation [SD], 3.2 years) who were assessed at 20 years post-injury (mild [n = 14],
Edith Botchway-Commey moderate [n = 27], and severe [n = 13] TBI) and 13 healthy controls (mean age,
(edith.botchway@mcri.edu.au) 26.0; SD, 2.1 years). Sleep was assessed with the Pittsburgh Sleep Quality Index and
Citation: Botchway-Commey E, actigraphy, and lifestyle factors were assessed with a study-designed questionnaire.
Godfrey C, Nicholas CL, et al., Objective sleep efficiency was not significantly different between the TBI and control
2023, Relationship between sleep
outcomes and lifestyle factors groups, but the control group presented with significantly better subjective sleep
in young adults who sustained quality compared to the mild and moderate TBI severity groups. Poor subjective
traumatic brain injury in childhood. sleep quality was significantly associated with evening chronotype (P < 0.001) and
Adv Neuro, 2(3): 0876.
https://doi.org/10.36922/an.0876 tobacco use (P < 0.001), while being a parent (P = 0.038) and alcohol use (P = 0.035)
were significantly associated with poorer objective sleep efficiency in the TBI group.
Received: April 28, 2023 These preliminary findings highlight interesting associations between poor sleep
Accepted: July 10, 2023 quality and lifestyle factors in young adults who sustained TBI in childhood. They
Published Online: August 3, 2023 highlight the need to further explore these relationships in this TBI population to
inform on potential avenues for sleep interventions.
Copyright: © 2023 Author(s).
This is an Open-Access article
distributed under the terms of the Keywords: Traumatic brain injury; Childhood; Young adulthood; Sleep; Lifestyle factors
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience
Publishing remains neutral with Traumatic brain injury (TBI) refers to an alteration to brain function, or other evidence
regard to jurisdictional claims in of brain pathology, caused by an external force [1,2] . Sustaining TBI in childhood has been
published maps and institutional
affiliations. associated with poor outcomes in several domains including cognition, behavior, mental

Volume 2 Issue 3 (2023) 1 https://doi.org/10.36922/an.0876