Research Reports - Evaluating the impact of treatment for sleep/wake disorders on recovery of cognition and communication in adults with chronic TBI

Brain Inj. 2013;27(12):1364-1376

Wiseman-Hakes C, Murray B, Moineddin R, Rochon E, Cullen N, Gargaro J, Colantonio A

Abstract Objective: To longitudinally examine objective and self-reported
outcomes for recovery of cognition, communication, mood and participation in
adults with traumatic brain injury (TBI) and co-morbid post-traumatic sleep/wake
disorders. Design: Prospective, longitudinal, single blind outcome study.
Setting: Community-based. Participants: Ten adults with moderate-severe TBI and
two adults with mild TBI and persistent symptoms aged 18-58 years. Six males and
six females, who were 1-22 years post-injury and presented with self-reported
sleep/wake disturbances with onset post-injury. Interventions: Individualized
treatments for sleep/wake disorders that included sleep hygiene recommendations,
pharmacological interventions and/or treatments for sleep apnea with follow-up.
Main outcome measures: Insomnia Severity Index, Beck Depression and Anxiety
Inventories, Latrobe Communication Questionnaire, Speed and Capacity of Language
Processing, Test of Everyday Attention, Repeatable Battery for the Assessment of
Neuropsychological Status, Daily Cognitive-Communication and Sleep Profile.
Results: Group analysis revealed positive trends in change for each measure and
across sub-tests of all measures. Statistically significant changes were noted in
insomnia severity, p = 0.0003; depression severity, p = 0.03; language, p = 0.01;
speed of language processing, p = 0.007. Conclusions: These results add to a
small but growing body of evidence that sleep/wake disorders associated with TBI
exacerbate trauma-related cognitive, communication and mood impairments.
Treatment for sleep/wake disorders may optimize recovery and outcomes.

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