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Principal Investigator: Cydni Nicole Williams
Organization: OREGON HEALTH & SCIENCE UNIVERSITY
Fiscal Year: 2024
Award: $130,608
Funding agency: National Heart Lung and Blood Institute
Project Summary
Sleep is critical for brain maturation and development in childhood, and for neuronal healing after injury.
Traumatic brain injury (TBI) is a common pediatric critical illness affecting more than 50,000 children annually,
half of whom suffer acute and chronic sleep wake disturbances (SWD) leading to impaired quality of life. These
children also suffer substantial cognitive impairments for many years after injury, particularly in domains of
executive function, leading to reduced academic performance and psychosocial dysfunction. Whether sleep
disturbances significantly compound these cognitive deficits after TBI remains unknown. Additionally, effective
therapies shown to prevent or improve SWD and executive dysfunction among these vulnerable children are
lacking. The central hypothesis of this proposal is that SWD are an independent and modifiable risk factor for
executive function impairment in children surviving TBI. The objectives of the proposed research are to: 1)
Determine the longitudinal association between SWD and executive function after pediatric TBI in a
prospective cohort study using both questionnaires and objective measures, 2) Evaluate feasibility and
effectiveness of an early melatonin and sleep management intervention started during hospitalization in a
single-center randomized controlled trial.
Dr. Cydni Williams is a Pediatric Critical Care physician at Oregon Health & Science University where she
cares for critically ill children acutely in the pediatric intensive care unit and longitudinally in a critical care
follow-up clinic. Her work has identified SWD as an important morbidity affecting more than half of critical care
survivors, particularly in the large number of TBI survivors she follows. Her long-term goal is to improve
longitudinal outcomes and quality of life through rigorous studies identifying effective interventions to improve
sleep disturbances after pediatric critical care, by first evaluating the high risk cohort of TBI survivors. This
career development proposal will provide Dr. Williams with experiential and mentored training conducting sleep
research, clinical trial methodology, and longitudinal data analyses. This proposal is significant because it
addresses the common and debilitating morbidity of SWD that affect thousands of pediatric TBI survivors
annually, advances clinical care and research through testing an early sleep management intervention, and
aligns with the National Institutes of Health Sleep Disorders Research Plan. This research and multi-
disciplinary mentored training will provide Dr. Williams with data and research expertise needed to pursue
independent research funding to evaluate SWD in pediatric TBI and other critical illness survivors.
Terms: <0-11 years old><Academic achievement><Active Follow-up><Acute><Acute Brain Injuries><Address><Affect><Anti-Inflammatories><Anti-Inflammatory Agents><Anti-inflammatory><Attention><Behavior><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral Conditioning Therapy><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><Brain><Brain Nervous System><Brain Trauma><Characteristics><Child><Child Care><Child Youth><Childhood><Children (0-21)><Chronic><Clinic><Clinical><Clinical Research><Clinical Study><Clinical Trials><Cognitive><Cognitive Disturbance><Cognitive Impairment><Cognitive decline><Cognitive deficits><Cognitive function abnormal><Conditioning Therapy><Critical Care><Critical Illness><Critically Ill><Critically ill children><Data><Data Analyses><Data Analysis><Development><Disturbance in cognition><Dysfunction><Early Intervention><Effectiveness><Encephalon><Equipment and supply inventories><Executive Dysfunction><Executive Function Deficit><Executive Impairment><Functional disorder><Funding><Goals><Health><History><Hospital Admission><Hospitalization><Impaired cognition><Impairment><Inflammatory><Injury><Intervention><Intervention Strategies><Inventory><K12><K12 Award><K12 Mechanism><K12 Program><Linear Regressions><Long-term cohort study><Longitudinal cohort study><Longterm cohort study><Maintenance><Measures><Melatonin><Memory><Mentored Clinical Scientist Development Program><Mentors><Mentorship><Methodology><Modeling><Monitor><Morbidity><Morbidity - disease rate><NIH><National Institutes of Health><Nerve Cells><Nerve Unit><Neural Cell><Neurocyte><Neurons><Oregon><Outcome><Patients with traumatic brain injury><Pediatric Intensive Care Units><Performance><Phenotype><Physicians><Physiopathology><Prevention><Problem behavior><Productivity><Property><Prospective, cohort study><Publications><Puericulture><QOL><Quality of life><Questionnaires><Randomized, Controlled Trials><Recording of previous events><Recovery><Research><Research Proposals><Risk Factors><Science><Scientific Publication><Sleep><Sleep Disorders><Sleep disturbances><Survivors><TBI Patients><TBI recovery><Targeted Research><Testing><Training><Traumatic Brain Injury><Traumatic Brain Injury recovery><United States National Institutes of Health><Universities><Work><Wrist><aberrant sleep><acceptability and feasibility><actigraph><actigraphy><active followup><aged><analyzing longitudinal><behavior intervention><behavioral intervention><behavioral problem><career development><clinical care><cognitive assessment><cognitive defects><cognitive dysfunction><cognitive loss><cognitive testing><cohort><cost><critically ill child><data interpretation><developmental><disrupted sleep><disturbed sleep><effective intervention><effective therapy><effective treatment><evidence base><executive control><executive function><follow up><follow-up><followed up><followup><healing><high risk><histories><impaired sleep><improved><improved outcome><improvement on sleep><injuries><interventional strategy><irregular sleep><kids><longitudinal analysis><malleable risk><modifiable risk><multi-modality><multidisciplinary><multimodality><neuronal><pathophysiology><patient centered><patient oriented><pediatric><pediatric TBI><pediatric traumatic brain injury><poor sleep><prevent><preventing><prospective><psychosocial><psychosocial outcome><psychosocial sequelae><randomized control trial><randomized placebo control trial><randomized placebo controlled trial><recovery after TBI><recovery after traumatic brain injury><skill acquisition><skill development><sleep diseases><sleep disruption><sleep dysfunction><sleep dysregulation><sleep illness><sleep improvement><sleep problem><standard care><standard treatment><traumatic brain damage><traumatic brain injury patients><youngster>