Research Reports - Sleep hygiene program implementation in patients with traumatic brain injury

Rehabil Nurs. 2013 Jan-Feb;38(1):2-10

De La Rue-Evans L, Nesbitt K, Oka RK

PURPOSE: Traumatic brain injury (TBI) is a serious public health problem. The
impact of TBI on the individual is multifaceted and includes neurocognitive,
behavioral, and psychiatric disturbances as well as greater predisposition for
dementia. A common but significant problem reported by patients after TBI is
sleep disturbance. The purpose of this manuscript is twofold: (1) to describe our
experience with implementation of the newly developed sleep hygiene guidelines;
and (2) to report our preliminary results of implementation of the sleep hygiene
guidelines on TBI patient outcomes.
METHODS: A mixed methods approach was used to assess implementation of sleep
hygiene guidelines and to gather preliminary data on outcomes.
RESULTS: Although not statistically significant, the average self-reported sleep
duration of these TBI patients was slightly higher in 2010 than 2009, with a FIM
score that was similar for both time points. In 2009, the mean change in
functional independence measure (FIM) score (n = 34) was 1.44. In 2010, the mean
change in FIM score (n = 33) was 1.42. In 2009, most patients (n = 13) admitted
to the hospital continued to take medications and were discharged with a sleep
aid. In 2010, most patients reported a change in their sleep medication
prescriptions (on medications at admission and none at discharge) or had
continued to take their prescribed sleep medications from admission to discharge
(n = 12).
CONCLUSION: Sleep disorders have a major impact on health outcomes in patients
with TBI. To optimize rehabilitation and ultimately improve functional outcomes
of patients with TBI, implementation of evidence-based clinical guidelines for
sleep is imperative. We report our initial experience with implementation of
sleep guidelines.

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