How Wearable Technology Could Improve Sleep and Concussion Recovery

Sleep plays a critical role in concussion recovery, and trouble sleeping is common after a concussion, often resulting in longer recovery times and worse outcomes. Researchers still don’t understand exactly what causes sleep changes after an injury and how those changes may affect healing. Additionally, misconceptions about sleep and concussions persist, including the long-standing myth that people with concussions should refrain from sleep. Getting a clearer picture of how sleep changes throughout recovery could help researchers better understand its role in concussion care.

To learn more and help confront these misconceptions, the Children’s Hospital Colorado team recently became one of the first pediatric concussion programs to use the Oura Ring to gather data on sleep and concussions. Children’s Colorado postdoctoral sports medicine researcher Cat Donahue, PhD, is using this wearable technology in her research to get a clearer picture of sleep throughout recovery and identify how that information could help improve concussion care.

Why is sleep difficult to study during concussion recovery?

Most concussion care happens during periodic clinic visits, but sleep happens every night. And what occurs between appointments can be difficult to capture — particularly when sleep patterns fluctuate from night to night. During a first clinical visit, care teams typically document a patient’s sleep through symptom reports and questionnaires, but these assessments may not fully capture how sleep changes throughout recovery. In earlier studies, research relied heavily on surveys and self-reported sleep data, which left gaps in the picture. That’s what led researchers to seek out another way to track sleep.

How can wearable technology help researchers study sleep after concussion?

Studying sleep outside a lab comes with its own challenges. Dr. Donahue and her team compared several tools for monitoring sleep at home, including portable EEG headbands, research-grade activity watches, sleep diaries and consumer wearables. They looked at factors such as accuracy, data quality and usability, missing data, participant adherence, overall cost and feasibility.

While at-home monitoring proved practical overall, the researchers found that how consistently participants used each tool varied significantly. This made ease of use an important consideration when choosing a device for longer-term research. But researchers also needed a tool that could provide detailed sleep data they could analyze over time. The Oura Ring offered a combination of both.

What can an Oura Ring reveal about sleep after concussion?

The Oura Ring combines the convenience of a consumer wearable with detailed sleep data researchers can use to study patterns. Using this data, researchers can easily see how someone sleeps night after night, including when they go to bed and wake up, how long it takes them to fall asleep (latency), how long they sleep, periods of wakefulness and sleep stages.

While consumers typically see summarized sleep information in the Oura application, researchers can access more detailed data of participants that are opted in to investigate specific aspects of sleep and physiology that may be relevant to concussion recovery. And because the Oura Ring was designed specifically for sleep and comfort, it has been particularly useful for studying sleep throughout concussion recovery, with 96% adherence among study participants.

“One of the exciting things about having access to such detailed data is that we can calculate additional measures that aren't necessarily available in the consumer app,” Dr. Donahue says. “For example, we can examine how consistent someone's sleep and wake times are, how their sleep varies from night to night and how different aspects of sleep and physiology change throughout recovery. We're trying to determine whether those patterns provide insights into concussion recovery that we wouldn't get from looking at sleep duration alone”

By analyzing the ring’s raw data, researchers can create a clear snapshot of sleep and look for patterns over time, including duration and quality of sleep, that could greatly affect concussion recovery.

Can sleep recommendations after concussion become more personalized?

Current concussion guidance often includes general sleep hygiene recommendations, but investigators believe a more individualized approach could lead to better outcomes. In addition to exploring what we can learn about sleep with a concussion, the team is also looking into how we can take that a step further. An NIH-funded intervention study led by the same team is now investigating individualized sleep plans tailored to each patient’s specific sleep challenges and habits.

“We’re hoping to guide concussion care from a one-size-fits-all model toward a precision medicine approach,” Dr. Donahue says.

Under this model, recommendations may include maintaining a consistent sleep schedule, reducing nighttime screen exposure, managing anxiety at bedtime and other strategies tailored to the individual.

What could this research mean for kids and teens that have a concussion?

Ultimately, researchers hope continuous sleep monitoring could help clinicians recognize potential problems earlier and personalize care throughout concussion recovery.

“Instead of waiting until a patient comes back to clinic and tells us they’re struggling, we’re hoping continuous monitoring can help us identify those signs earlier for treatment,” Dr. Donahue says.

Together, these studies could help move concussion care beyond one-size-fits-all sleep recommendations. By identifying which aspects of sleep may be important during recovery and testing strategies to address individual sleep challenges, researchers hope to improve sleep, support faster symptom recovery and potentially improve longer-term outcomes like mental health and academic engagement.

“Ultimately, our goal isn't just to collect more data; it's to generate better evidence to guide how we care for kids recovering from concussion,” Dr. Donahue states. “We want to understand whether the information we can capture through wearables tells us something meaningful about recovery that we're not seeing during clinic visits, and whether that knowledge can eventually help us provide more individualized, evidence-based care.”