Research Reports - Risk factors associated with sleep disturbance following traumatic brain injury

PLoS One. 2013 Oct 1;8(10)

Hou L, Han X, Sheng P, Tong W, Li Z, Xu D, Yu M, Huang L, Zhao Z, Lu Y, Dong Y

BACKGROUND: Sleep disturbance is very common following traumatic brain injury
(TBI), which may initiate or exacerbate a variety of co-morbidities and
negatively impact rehabilitative treatments. To date, there are paradoxical
reports regarding the associations between inherent characteristics of TBI and
sleep disturbance in TBI population. The current study was designed to explore
the relationship between the presence of sleep disturbance and characteristics of
TBI and identify the factors which are closely related to the presence of sleep
disturbance in TBI population.
METHODS: 98 TBI patients (72 males, mean age ± SD, 47 ± 13 years, range 18-70)
were recruited. Severity of TBI was evaluated based on Glasgow Coma Scale (GCS).
All participants performed cranial computed tomography and were examined on
self-reported sleep quality, anxiety, and depression.
RESULTS: TBI was mild in 69 (70%), moderate in 15 (15%) and severe in 14 (15%)
patients. 37 of 98 patients (38%) reported sleep disturbance following TBI.
Insomnia was diagnosed in 28 patients (29%) and post-traumatic hypersomnia in 9
patients (9%). In TBI with insomnia group, 5 patients (18%) complained of
difficulty falling asleep only, 8 patients (29%) had difficulty maintaining sleep
without difficulty in initial sleep and 15 patients (53%) presented both
difficulty falling asleep and difficulty maintaining sleep. Risk factors
associated with insomnia were headache and/or dizziness and more symptoms of
anxiety and depression rather than GCS. In contrast, GCS was independently
associated with the presence of hypersomnia following TBI. Furthermore, there was
no evidence of an association between locations of brain injury and the presence
of sleep disturbance after TBI.
CONCLUSION: Our data support and contribute to a growing body of evidence which
indicates that TBI patients with insomnia are prone to suffer from concomitant
headache and/or dizziness, report more symptoms of anxiety and depression and
severe TBI patients are likely to experience hypersomnia.

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