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Advanced Neurology Sleep and lifestyle factors in young adults with childhood TBI

robustness of the findings. (ii) Information about possible Funding
additional brain injuries in the TBI group in the years
following their first injury is a potential confounding This project is supported by the Australian National Health
factor, which was not measured in this study. (iii) The and Medical Research Council project and fellowship
findings regarding the significant relationships between funding, Victorian Operational Infrastructure fund.
sleep outcomes and substances such as alcohol and tobacco Edith Botchway-Commey was funded by the University
use should be interpreted with caution because critical of Melbourne International Fee Remission and the
questions around dose, type, timing, frequency, duration, Melbourne International Research Scholarships.
and reason for using these substances were not assessed Conflict of interest
in the present study. (iv) We are unable to draw casual
inferences between TBI and the identified factors due to The authors declare that they have no competing interests.
the cross-sectional nature of this evaluation.
Author contributions
4.2. Clinical implications
Conceptualization: Edith Botchway-Commey, Celia
Some clinical implications of our findings are as follows. Godfrey, Vicki Anderson, Cathy Catroppa
The significant association between poor sleep quality and Formal analysis: Edith Botchway-Commey, Christian L.
evening chronotype highlights greater vulnerability to Nicholas
[40]
sleep problems in young adults with childhood TBI who Investigation: Edith Botchway-Commey, Celia Godfrey,
have an evening chronotype and suggests the need to pay Vicki Anderson, Cathy Catroppa
attention to those with this risk factor. Although being a Methodology: All authors
parent with a young child is a known risk factor for poor Project administration: Edith Botchway-Commey, Celia
sleep [47,49] , young adults with TBI may be more vulnerable Godfrey, Vicki Anderson, Cathy Catroppa
to such problems because of the potential impact of TBI on Supervision: Celia Godfrey, Vicki Anderson, Cathy
sleep-related brain mechanisms and should be supported Catroppa
with interventions to help improve their sleep outcomes. Writing – original draft: Edith Botchway-Commey
Clinicians and young people living with a childhood Writing – review & editing: All authors
TBI should be informed about the identified relationship
between tobacco, alcohol use, and sleep outcomes, with Ethics approval and consent to participate
due consideration for the lack of information about dose, This study was approved by the Human Research
type of medication, duration of use, and frequency of use
in this study. Ethics Committee of The Royal Children’s Hospital (RCH
– HREC Ref No: 30064), Melbourne, Australia.
5. Conclusion
Consent for publication
This study investigated the relationships between sleep All participants provided written consent for this study,
subjective and objective outcomes, and lifestyle factors
in young adults who sustained TBI in childhood. Results using the Study Information Statement and Consent Form,
highlight lifestyle factors associated with subjective which included information about intentions to publish
(i.e., chronotype and tobacco use) and objective sleep the results from this study in peer-reviewed journals.
(alcohol and being a parent) outcomes in this young adult Availability of data
TBI sample. These preliminary findings highlight some
potential modifiable factors, raise interesting issues for Not applicable.
clinical consideration, and indicate the need for further
investigations of these relationships to identify more Further disclosure
avenues for sleep interventions in young adult survivors of Part of the findings (specifically mean group differences
childhood TBI. of subjective and objective sleep outcomes) has been
previously published (DOI: 10.1089/neu.2018.5743; DOI:
Acknowledgments 10.1080/09638288.2019.1578422). However, the present

We thank the Victorian Electoral Commission (Australia) analysis extends these previous reports by looking at
for their support with participant recruitment and group differences in lifestyle factors and teasing out the
appreciate all participating families for their dedication to differences in outcome between each TBI severity group
this longitudinal study. and the control group.

Volume 2 Issue 3 (2023) 9 https://doi.org/10.36922/an.0876