Sleep Measure Validation in a Pediatric Neurocritical Care Acquired Brain Injury Population

  • Katrina M. Poppert Cordts
  • Trevor A. Hall
  • Mary E. Hartman
  • Madison Luther
  • Amanda Wagner
  • Juan Piantino
  • Kristin P. Guilliams
  • Rejean M. Guerriero
  • Jalane Jara
  • Cydni N. WilliamsEmail author
Original Work



Lingering morbidities including physical, cognitive, emotional, and psychosocial sequelae, termed the Post-Intensive Care Syndrome, persist years after pediatric neurocritical care (PNCC) hospitalization. Sleep disturbances impact other Post-Intensive Care Syndrome domains and are under-evaluated to date due to a lack of appropriate measurement tools. The present study evaluated the validity of the Sleep Disturbance Scale for Children (SDSC) to address the growing need for assessing sleep problems after PNCC.


We conducted a prospective observational study of youth aged 3–17 years with acquired brain injury (N = 69) receiving care through longitudinal PNCC programs at two tertiary academic medical centers. Parents completed the SDSC and provided proxy reports of internalizing symptoms, health-related quality of life (HRQOL), fatigue, pain behavior, and cognitive function within 3 months of hospital discharge. Evidence for the validity of the SDSC was established by utilizing the full sample for psychosocial measure comparisons and by comparing SDSC outcomes by severity (Low Risk, Mild-Moderate Risk, and High Risk defined by reported standardized T-scores).


Internal consistency of the SDSC was good (α = .81). Within the full sample, increased sleep disturbances on the SDSC were significantly correlated with Post-Intensive Care Syndrome measures, including worse physical (r = .65), psychological (r = .62), and cognitive (r = − .74) sequelae. Youth in the High Risk group evidenced greater dysfunction in mental acuity, pain behavior, internalizing symptoms, and social engagement. Findings revealed both statistically and clinically significant impacts of sleep disturbances as measured by the SDSC on HRQOL.


The SDSC is a valid and reliable measure for assessing sleep disturbances in children after PNCC. Results support the use of the SDSC to measure sleep disturbances after PNCC. Targeted interventions for sleep disturbances may be key to overall patient recovery.


Critical care Sleep Quality of life Hospitalization Pediatric Outcomes Brain injury 



Williams is supported by the Agency for Healthcare Research and Quality, grant number K12HS022981. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. Dr. Guilliams is supported by the National Institute of Neurologic Disorders and Stroke grant number K23NS099472. Dr. Piantino is supported by the National Heart, Lung and Blood Institute grant number K12HL133115.

Source of support

Dr. Cordts was involved in all aspects of manuscript preparation, including conceptualization, conducting statistical analyses, and writing of the manuscript. Drs. Hall and Wagner were involved in the study conceptualization, data collection, and writing of the manuscript. Dr. Williams supervises Ms. Madison Luther and Ms. Jalane Jara who assisted with data collection, entry, and writing of the manuscript. Dr. Williams was involved in all aspects of the research from conceptualization of the study to editing the manuscript. Drs. Piantino, Hartman, Guilliams, Guerriero assisted in data collection and editing the manuscript.

Informed consent

This study was approved by the Institutional Review Board and conducted with a waiver of informed consent.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019

Authors and Affiliations

  • Katrina M. Poppert Cordts
    • 1
    • 2
  • Trevor A. Hall
    • 2
    • 3
  • Mary E. Hartman
    • 4
  • Madison Luther
    • 3
  • Amanda Wagner
    • 2
  • Juan Piantino
    • 5
  • Kristin P. Guilliams
    • 4
    • 6
  • Rejean M. Guerriero
    • 6
  • Jalane Jara
    • 3
  • Cydni N. Williams
    • 3
    • 7
    Email author
  1. 1.Department of PsychiatryUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Division of Pediatric Psychology, Department of Pediatrics, Institute on Development and DisabilityOregon Health and Science University and Doernbecher Children’s HospitalPortlandUSA
  3. 3.Pediatric Critical Care and Neurotrauma Recovery ProgramOregon Health and Science UniversityPortlandUSA
  4. 4.Division of Pediatric Critical Care, Department of PediatricsWashington University School of Medicine, St. Louis Children’s HospitalSt. LouisUSA
  5. 5.Division of Pediatric Neurology, Department of PediatricsOregon Health and Science University and Doernbecher Children’s HospitalPortlandUSA
  6. 6.Division of Pediatric and Developmental Neurology, Department of NeurologyWashington University School of Medicine, St Louis Children’s HospitalSt. LouisUSA
  7. 7.Division of Pediatric Critical Care, Department of PediatricsOregon Health and Science University and Doernbecher Children’s HospitalPortlandUSA

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