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Objective <p>To investigate the influence of environmental factors on sleep in children and adults recovering from acquired brain injury (ABI).</p> Design <p>Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with a narrative synthesis due to study heterogeneity.</p> Subjects/Patients <p>Studies including children and adults with ABI in hospital or community settings, where environmental exposures and sleep outcomes were reported.</p> Methods <p>Five databases (PubMed, Embase, CINAHL, PsycINFO, Cochrane) were searched for studies published before January 2025. Inclusion criteria focused on human studies of ABI populations with documented environmental exposures and sleep outcome measures.</p> Results <p>Seven studies involving 595 participants were included. No studies included children. Noise was measured with a sound meter in one study and reported with questionnaire in one study. Environmental noise overnight was frequently above recommended levels. Light was measured with a light meter in three studies and reported with a questionnaire in one study. Light exposure was above recommended levels overnight and below recommended levels during daytime. Nursing was measured in one study as movement in the room with a bedside movement sensor and in two studies as overnight episodes of nursing care. Higher acuity rehabilitation patients had nursing care interruptions averaging five episodes per night. Noise, light and nursing care interruptions were associated with poor sleep outcomes, particularly increased wake after sleep onset (WASO) and reduced sleep efficiency (SE). Two of three hospital sleep hygiene interventions showed improvement in sleep or reduced sedative use.</p> Conclusion <p>People recovering from ABI experience significant sleep disturbance in hospital and community settings, often exacerbated by environmental factors. Despite sleep being critical to brain recovery, few high-quality studies exist, and none focus on children. There is an urgent need for paediatric research and for integrating environmental sleep health practices into ABI rehabilitation.</p>

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The Influence of Environmental Factors on Sleep During Recovery from Acquired Brain Injury: A Systematic Review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • Rebecca Greenslade,
  • Nevin Haynes,
  • Karen M. Barlow

摘要

Objective

To investigate the influence of environmental factors on sleep in children and adults recovering from acquired brain injury (ABI).

Design

Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with a narrative synthesis due to study heterogeneity.

Subjects/Patients

Studies including children and adults with ABI in hospital or community settings, where environmental exposures and sleep outcomes were reported.

Methods

Five databases (PubMed, Embase, CINAHL, PsycINFO, Cochrane) were searched for studies published before January 2025. Inclusion criteria focused on human studies of ABI populations with documented environmental exposures and sleep outcome measures.

Results

Seven studies involving 595 participants were included. No studies included children. Noise was measured with a sound meter in one study and reported with questionnaire in one study. Environmental noise overnight was frequently above recommended levels. Light was measured with a light meter in three studies and reported with a questionnaire in one study. Light exposure was above recommended levels overnight and below recommended levels during daytime. Nursing was measured in one study as movement in the room with a bedside movement sensor and in two studies as overnight episodes of nursing care. Higher acuity rehabilitation patients had nursing care interruptions averaging five episodes per night. Noise, light and nursing care interruptions were associated with poor sleep outcomes, particularly increased wake after sleep onset (WASO) and reduced sleep efficiency (SE). Two of three hospital sleep hygiene interventions showed improvement in sleep or reduced sedative use.

Conclusion

People recovering from ABI experience significant sleep disturbance in hospital and community settings, often exacerbated by environmental factors. Despite sleep being critical to brain recovery, few high-quality studies exist, and none focus on children. There is an urgent need for paediatric research and for integrating environmental sleep health practices into ABI rehabilitation.