Study Links Extended Sleep Post-Concussion in Youth to Elevated Symptoms

In a pivotal observational study published in JAMA Network Open on July 2, 2025, researchers discovered a significant correlation between prolonged sleep duration following acute concussion in adolescents and an increased burden of symptoms thereafter. The study, led by Lauren Butterfield, MSc, from the Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada, highlights the critical need for clinicians to monitor sleep patterns in youth patients recovering from concussions.

The research aimed to explore how sleep duration impacts symptom severity in young individuals who have suffered concussions. A cohort of 291 participants, aged between 10 and 18 years, was analyzed, all of whom received treatment for concussions within 48 hours of injury. According to the findings, adolescents who reported an average nightly sleep duration exceeding 9.9 hours during the first two weeks post-injury exhibited a higher symptom burden at 1, 2, and 4 weeks following the concussion.

Data were collected from three pediatric emergency departments in Ontario between March 2017 and December 2019. Participants wore waist accelerometers to measure sleep continuously over the two-week period, while daily sleep logs supplemented these measurements. The Health and Behavior Inventory was employed to assess symptom burden at designated recovery intervals.

The study's results indicated that youths averaging more than 9.5 hours of sleep in the first week post-concussion had significantly higher symptom burdens compared to those with lesser sleep durations. Specifically, the 75th percentile group, who averaged 10.5 hours of sleep, reported a symptom burden increase of 1.3 (95% CI, 0.25-2.28) compared to the 25th percentile group, averaging 9.5 hours. Furthermore, the findings showed that those sleeping over 9.9 hours were not only more symptomatic at the 2-week mark but also displayed increased odds of persisting symptoms at 4 weeks, with odds ratios of 1.73 (95% CI, 0.91-3.26) under conservative definitions and 1.93 (95% CI, 1.07-3.47) under liberal definitions.

Dr. Sarah Johnson, a pediatric neurologist at the Mayo Clinic, emphasized the implications of these findings, stating, "This study underscores the necessity for healthcare providers to assess sleep duration closely in youth concussion patients, as longer sleep could indicate underlying issues that may exacerbate recovery."

The current research aligns with the growing body of evidence suggesting that sleep disturbances are prevalent among youth recovering from concussions, with nearly 50% experiencing sleep issues during the initial week of recovery. The findings call for further investigation into the long-term effects of sleep patterns on recovery and the potential for targeted interventions.

Looking ahead, the implications of this research are profound. As concussions remain a significant concern in youth sports and activities, understanding the relationship between sleep duration and symptom severity could lead to enhanced recovery protocols and improved outcomes for young athletes. Health professionals are encouraged to prioritize sleep assessments in their post-concussion management strategies to better support youth recovery processes.

In summary, the study by Butterfield et al. illustrates a critical association between extended sleep duration post-concussion and increased symptom burden in youths, advocating for a more vigilant approach to sleep monitoring in clinical practice. The full study can be referenced in JAMA Network Open (Butterfield L, Zemek R, Borghese MM, et al. Nightly Sleep Duration and Symptom Burden Over 1 Month Following Pediatric Concussion. JAMA Netw Open. 2025;8(6):e2516333. doi:10.1001/jamanetworkopen.2025.16333).