A – 43 Sleep and Cognition in a Pediatric Acquired Brain Injury Post-Pediatric Intensive Care Unit (PICU) Sample

Objective Pediatric intensive care unit (PICU) survivors with acquired brain injury (ABI) have increased risk for sleep disturbances that can affect recovery. We aimed to determine the prevalence of sleep problems after hospitalization in children with ABI, and to evaluate associations between parent-reported sleep and executive functioning (EF) with performance-based cognitive outcomes. Method After clinical referral from early triage screening (4-6 weeks post-hospital discharge), 110 youth aged 6-19 years completed neuropsychological evaluation (9-12 months post-hospital discharge), 83 of whom had concurrent caregiver-completed Sleep Disturbance Scale for Children (SDSC) and Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF-2). Scores from the SDSC and the BRIEF-2 were compared to the Cognitive Status Scale (CSS), a psychometrically robust tool for summarizing flexible assessment batteries into a single performance-based outcomes research metric (CSS Total Score), as well as subdomain scores. Relationships were evaluated using Spearman correlation (rs). Results Clinically significant sleep concerns (any SDSC T-score ≥60) were observed in 69% of the sample. A significant association was observed between the SDSC Total Score and the BRIEF-2 Global Executive Composite (rs=.383, p=.01). While the SDSC Total Score was not associated with the CSS Total Score (rs= -.058), significant correlation was observed between CSS Learning and Memory and SDSC Sleep Breathing Disorder subdomain scores (rs= -.251, p=.05). Conclusion Parent reported sleep disturbances in PICU survivors with ABI are associated with daily life EF performance in the long-term. Interventions targeting sleep throughout ABI recovery are essential and may have positive real word impact on EF.