Nightly Sleep Duration and Symptom Burden Over 1 Month Following Pediatric Concussion
Notice bibliographique
Résumé
Importance: Approximately half of all youths with concussions report sleep disturbance, including short and long sleep durations, in the first week of recovery. Limited longitudinal research exists regarding the association between sleep duration and symptom burden during acute pediatric concussion recovery. Objective: To investigate the association between mean nightly sleep duration over 1 week (days 1 to 7) and 2 weeks (days 1 to 14) postinjury and subsequent symptom burden at 1, 2, and 4 weeks following pediatric concussion. Design, Setting, and Participants: This cohort study used data from a randomized clinical trial conducted in 3 emergency pediatric departments in Ontario, Canada, from March 2017 to December 2019 (with secondary analysis conducted between September 2022 and September 2024). Eligible participants were between ages 10 years and 18 years who received treatment for a concussion within 48 hours. Exposure: Sleep postinjury was measured with waist-worn accelerometers 24 hours per day for 2 weeks and daily sleep logs. Main Outcomes and Measures: Symptom burden was measured with the Health and Behavior Inventory at 1 week, 2 weeks, and 4 weeks postconcussion. A nonlinear mixed-effects model was applied that estimated symptom burden at 1, 2, and 4 weeks from mean sleep duration over days 1 to 7 and days 1 to 14. Logistic regressions were performed to assess the odds of being reliably symptomatic at 2 and 4 weeks by mean sleep duration. Conservative (z ≥ 1.65) and liberal (z ≥ 1.28) definitions of reliable change in symptoms were evaluated. All models compared 10th vs 50th, 25th vs 75th, and 50th vs 90th percentile contrasts, and were adjusted for prognostic pre-injury demographic and baseline injury variables. Results: A total of 291 participants (median [IQR] age, 13.2 [11.6-14.9] years; 128 female [44.0%]) were included in the main analysis. Mean nightly sleep duration beyond 9.5 hours in the first week postconcussion was associated with higher symptom burden at 1 week (75th percentile [10.5 h] vs 25th percentile [9.5 h]: estimate, 1.3 [95% CI, 0.25-2.28]; 90th percentile [11.3 h] vs 50th percentile [10.0 h]: estimate, 2.9 [95% CI, 1.22-4.69]). Mean sleep duration beyond 9.9 hours in the first 2 weeks postconcussion was associated with higher symptom burden at 2 weeks (90th percentile [10.9 h] vs 50th percentile [9.9 h]: estimate, 2.2 [95% CI, 0.85-3.47]) and 4 weeks (estimate, 2.2 [95% CI, 0.85-3.47]), and increased odds of persisting symptoms at 4 weeks (conservative: odds ratio [OR], 1.73 [95% CI, 0.91-3.26]; liberal: OR, 1.93 [95% CI, 1.07-3.47]). Conclusions and Relevance: In this observational study of adolescents, average nightly sleep durations beyond 9.9 hours over the first 2 weeks of concussion recovery were associated with high symptom burden and persistent symptoms. Clinicians should monitor youths' sleep after concussions.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».