Research Reports - Poor sleep predicts subacute postconcussion symptoms following mild traumatic brain injury

Appl Neuropsychol Adult. 2016 May 16:1-10. [Epub ahead of print]

Sullivan KA(1,)(2), Berndt SL(1), Edmed SL(1,)(2), Smith SS(1,)(2,)(3,)(4), Allan

The primary objective was to determine if poor sleep predicts postconcussion
symptoms in the subacute period after mild traumatic brain injury (TBI). The
impact of poor sleep pre- and post-injury was examined. The research design was
cross-sectional. After screening to detect response invalidity, 61 individuals
with a self-reported history of mild TBI 1-to-6 months prior answered an online
fixed order battery of standardized questionnaires assessing their sleep (current
and preinjury) and persistent postconcussion symptoms (Neurobehavioral Symptom
Inventory, minus sleep, and fatigue items). The sleep measures were the Insomnia
Severity Index, Epworth Sleepiness Scale, a single Likert-scale pre-injury sleep
quality rating, and two PROMIS™ measures (sleep-related impairment and sleep
disturbance). After controlling for the effects of preinjury sleep quality and
demographics, the combination of the sleep measures made a significant
contribution to the outcome (F[8,58] = 4.013, p = .001, [Formula: see text]).
Only current sleep-related impairment (ß = .60, p < .05) made a significant and
unique contribution to neurobehavioral symptoms. Preinjury sleep was not a
predictor (ß = -.19, p > .05), although it contributed 3% of the variance in NSI
scores after controlling for demographics. Sleep-related impairment is a
modifiable factor. As a significant contributor to neurobehavioral symptoms,
treatment for post-injury sleep-related impairment warrants further attention. 

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