Research Reports - Does acute TBI-related sleep disturbance predict subsequent neuropsychiatric disturbances?

Brain Inj. 2014;28(1):20-6

Rao V, McCann U, Han D, Bergey A, Smith MT

PRIMARY OBJECTIVE: To determine whether sleep disturbance in the acute
post-traumatic brain injury (TBI) period predicts symptoms of depression, anxiety
or apathy measured 6 and 12 months after TBI.
RESEARCH DESIGN: Longitudinal, observational study.
METHODS AND PROCEDURES: First time closed-head injury patients (n = 101) were
recruited and evaluated within 3 months of injury and followed longitudinally,
with psychiatric evaluations at 6 and 12 months post-injury. Pre- and post-injury
sleep disturbances were measured via the Medical Outcome Scale (MOS) for Sleep.
Subjects were also assessed for anxiety, depression, apathy, medical comorbidity
and severity of TBI.
MAIN OUTCOMES AND RESULTS: Sleep disturbance in the acute TBI period was
associated with increased symptoms of depression, anxiety and apathy 12 months
post-injury.
CONCLUSIONS: Sleep disturbances experienced soon after trauma (i.e. <3 months
after injury) predicted neuropsychiatric symptoms 1 year after injury, raising
two important clinical questions: (1) Is sleep disturbance soon after trauma a
prognostic marker of subsequent neuropsychiatric symptoms? and (2) Can early
treatment of sleep disturbance during the post-TBI period reduce subsequent
development of neuropsychiatric symptoms? Future studies with larger sample sizes
and appropriate control groups could help to answer these questions, using
evidence-based methods for evaluating and treating sleep disturbances.

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