Research Reports - Excessive sleep need following traumatic brain injury

J Sleep Res. 2013 Dec;22(6):634-9

Sommerauer M, Valko PO, Werth E, Baumann CR

Increased sleep need following traumatic brain injury, referred to in this study
as post-traumatic pleiosomnia, is common, but so far its clinical impact and
therapeutic implications have not been characterized. We present a case-control
study of 36 patients with post-traumatic pleiosomnia, defined by an increased
sleep need of at least 2 h per 24 h after traumatic brain injury, compared to 36
controls. We assessed detailed history, sleep-activity patterns with sleep logs
and actigraphy, nocturnal sleep with polysomnography and daytime sleep propensity
with multiple sleep latency tests. Actigraphy recordings revealed that traumatic
brain injury (TBI) patients had longer estimated sleep durations than controls
(10.8 h per 24 h, compared to 7.3 h). When using sleep logs, TBI patients
underestimated their sleep need. During nocturnal sleep, patients had higher
amounts of slow-wave sleep than controls (20 versus 13.8%). Multiple sleep
latency tests revealed excessive daytime sleepiness in 15 patients (42%), and 10
of them had signs of chronic sleep deprivation. We conclude that post-traumatic
pleiosomnia may be even more frequent than reported previously, because affected
patients often underestimate their actual sleep need. Furthermore, these patients
exhibit an increase in slow-wave sleep which may reflect recovery mechanisms,
intrinsic consequences of diffuse brain damage or relative sleep deprivation.

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