The primary objective was to determine if poor sleep predicts postconcussion symptoms in the subacute period after mild traumatic brain injury (TBI). The impact of poor sleep pre- and post-injury was examined. The research design was cross-sectional. After screening to detect response invalidity, 61 individuals with a self-reported history of mild TBI 1-to-6 months prior answered an online fixed order battery of standardized questionnaires assessing their sleep (current and preinjury) and persistent postconcussion symptoms (Neurobehavioral Symptom Inventory, minus sleep, and fatigue items). The sleep measures were the Insomnia Severity Index, Epworth Sleepiness Scale, a single Likert-scale pre-injury sleep quality rating, and two PROMIS™ measures (sleep-related impairment and sleep disturbance). After controlling for the effects of preinjury sleep quality and demographics, the combination of the sleep measures made a significant contribution to the outcome (F[8,58] = 4.013, p = .001, [Formula: see text]). Only current sleep-related impairment (ß = .60, p < .05) made a significant and unique contribution to neurobehavioral symptoms. Preinjury sleep was not a predictor (ß = -.19, p > .05), although it contributed 3% of the variance in NSI scores after controlling for demographics. Sleep-related impairment is a modifiable factor. As a significant contributor to neurobehavioral symptoms, treatment for post-injury sleep-related impairment warrants further attention.
Keywords: Concussion; insomnia; mild traumatic brain injury; postconcussion symptoms; sleep.