A cross-sectional pretest data analysis of a randomized controlled trial was conducted to explore the intermediary function of sleep quality in the correlation between depression and concussion symptoms. Additionally, the study aimed to assess the moderating impact of resilience on this mediated model.

A survey was conducted on 249 adult volunteers suffering from brain injury (Glasgow Coma Scale 13–15). The study focused on outcome variables including depression (examined with the Beck Depression Inventory II), resilience (measured by the Resilience Scale for Adults), sleep quality (evaluated through the Pittsburgh Sleep Quality Index), and concussion symptoms (assessed using the Rivermead Post-Concussion Symptom Questionnaire). Data analysis employed moderated mediation regressions using the SPSS PROCESS macro.

Among individuals with mild traumatic brain injury, a notable positive association was observed between depression and concussion symptoms, with sleep quality identified as a substantial mediating factor. Furthermore, resilience played a pivotal role as a negative moderator in the connections between depression and sleep quality. Patients having lower levels of resilience exhibited a more pronounced adverse impact of sleep quality on depression.

In conclusion, mitigating depression risk in mild traumatic brain injury requires addressing both concussion symptoms and sleep disturbances, emphasizing the protective role of resilience, particularly in those with lower levels of resilience.