Self-Reported Changes to Nighttime Sleep After Traumatic Brain Injury

Parcell, Diane L.; Ponsford, Jennie Louise; Rajaratnam, Shanthakumar M W; Redman, Jennifer R.

doi:10.1016/j.apmr.2005.10.024

Cited by 133 publications

(106 citation statements)

References 54 publications

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“…Some previous studies have shown that mild TBI is associated with more sleep complaints as compared to moderate to severe TBI. 49,50 This may be because those with mild TBI retain more self-awareness. 7 Insult to the brain is considered a determinant of sleep disturbances, however, no convincing neuroimaging evidence has linked location of cerebral injury with sleep disturbance.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbances in Traumatic Brain Injury: A Meta-Analysis

Grima

Ponsford

Rajaratnam

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Sleep disturbances are frequently reported following traumatic brain injury (TBI); however, the exact disturbances remain unclear. This meta-analysis aimed to characterize sleep disturbance in community dwelling patients with TBI as compared to controls. Methods: Two investigators independently conducted a systematic search of multiple electronic databases from inception to May 27, 2015. Studies were selected if they compared sleep in community dwelling individuals with TBI relative to a control population without head injury. Data were pooled in metaanalysis with outcomes expressed as the standard mean difference (SMD) and 95% confidence interval (CI). The primary outcomes were derived from polysomnography and secondary outcomes were derived from subjective sleep measures. Results: Sixteen studies were included, combining 637 TBI patients and 567 controls, all of whom were community dwelling. Pooled polysomnography data revealed that TBI patients had poorer sleep efficiency (SMD = −0. I NTRO DUCTI O NSleep disturbances are frequently reported following traumatic brain injury (TBI), with over 50% of people experiencing some form of sleep disturbance post TBI.1 Although a large majority of people with TBI generally make a good physical recovery, disrupted sleep can often go untreated, impacting quality of life, impeding rehabilitation and return to pre-injury activities.2-5 Our recent work showed significant interrelationships between daytime sleepiness, daytime fatigue, cognitive impairment, and mood disturbances in TBI. 6 While individuals with TBI are known to report sleep problems, 1 the specific changes to sleep remain poorly characterized.7 Studies have been limited by small sample sizes, with variable and inconsistent findings. [8][9][10][11][12] This makes for a difficult characterization of sleep post TBI. Thus, there is a need to establish the specific aspects of sleep that are most affected post TBI as these have important implications for treatment and rehabilitation. The aim of the current meta-analysis was to characterize both objective sleep disturbances and subjective sleep complaints in individuals with TBI relative to healthy controls. Study outcomes included the comparison of TBI patients to controls across both polysomnography and subjective measures of sleep. It ; Matthew P. Pase, PhD was hypothesized that those with TBI would display widespread objective and subjective sleep deficits as compared to controls without head injury. The present study aimed to summarize current literature, which would identify important avenues for future research. M ETHO DS Study DesignThe search strategy was conducted in accordance with the meta-analysis of observational studies in epidemiology guidelines. 13 Article SearchingOvid Medline, Embase, PsychInfo, Scopus, and the Cochrane Library were systematically searched until May, 27 2015. The search was initially developed by all authors and refined by a librarian at Monash University. The references of recent publications were also hand searc...

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Section: Discussionmentioning

confidence: 99%

Sleep Disturbances in Traumatic Brain Injury: A Meta-Analysis

Grima

Ponsford

Rajaratnam

et al. 2016

Journal of Clinical Sleep Medicine

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“…There are inherent limitations to self-report questionnaires [47]. Subjective measures of sleep quality and daytime functioning reflect the patient's experience of sleep, which are essential for the diagnosis of sleep disorders and evaluation of treatments.…”

Section: Self-report Questionnairesmentioning

confidence: 99%

“…Further, self-report can be compromised based on injury-related cognitive impairment, recency or salience effects (i.e., remembering only the most recent or unusual experiences), or reliance on data from indirect sources such as caregivers or parents of children [40]. For example, patients in hospitals or institutionalized settings (e.g., following polytrauma) have sleep-wake schedules and daily routines imposed upon them and are also frequently disrupted by medical practitioners and monitoring, which may mask existing sleep problems or contribute to the development of new sleep difficulties [47].…”

Section: Self-report Questionnairesmentioning

confidence: 99%

“…Sleep diaries have been used to demonstrate sleep disturbances in patients with mTBI relative to matched controls [47], as well as to measure treatment response to sleep treatments such as cognitive behavioral treatment for insomnia (CBTI) [48,49]. Sleep diaries offer the advantage of prospectively capturing sleep-wake patterns and behaviors that may interfere with or promote sleep, including the regularity of bed times and rise times, the frequency, timing, and duration of daytime naps, use of prescribed or nonprescribed stimulants (e.g., energy drinks, caffeine) or central nervous system depressants, including alcohol, and other relevant behaviors.…”

Section: Sleep Diariesmentioning

confidence: 99%

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Sleep, Sleep Disorders, and Mild Traumatic Brain Injury. What We Know and What We Need to Know: Findings from a National Working Group

et al. 2016

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Disturbed sleep is one of the most common complaints following traumatic brain injury (TBI) and worsens morbidity and long-term sequelae. Further, sleep and TBI share neurophysiologic underpinnings with direct relevance to recovery from TBI. As such, disturbed sleep and clinical sleep disorders represent modifiable treatment targets to improve outcomes in TBI. This paper presents key findings from a national working group on sleep and TBI, with a specific focus on the testing and development of sleep-related therapeutic interventions for mild TBI (mTBI). First, mTBI and sleep physiology are briefly reviewed. Next, essential empirical and clinical questions and knowledge gaps are addressed. Finally, actionable recommendations are offered to guide active and efficient collaboration between academic, industry, and governmental stakeholders.

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“…Drawing on a convenience sample of 20 younger stroke Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). The ESS is a valid and reliable measure of daytime sleepiness [16][17][18] and has been successfully used with traumatic brain injury and stroke patients [9,10,13,19,20]. It measures daytime sleepiness using eight items on a four-point-likert-scale ranging between 0-6 for low sleepiness, 7-9 for average sleepiness and 10-24 for severe sleepiness.…”

Section: Introductionmentioning

confidence: 99%

Time to wake-up: Sleep problems and daytime sleepiness in long-term stroke survivors

et al. 2008

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Background and purpose: In work with chronic stroke patients the authors observed that patients frequently appear sleepy and often comment on their poor sleep. Sleep difficulties are frequently reported and indeed clinically recognized in the acute phase post-stroke, but little is known about the sleep and daytime sleepiness of chronic stroke patients with sustained disabilities. The latter, however, deserves clarification because sleep is a critical modulator of health, daytime performance and wellbeing. The present study therefore explored the sleep and sleepiness in a chronic stroke population with sustained physical deficits. Methods: An opportunity sample of 20 patients with chronic low-functioning hemiplegia (12 months) completed the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Medical Outcome Study Short Form 36 and Hospital Anxiety and Depression Scale. Results: Compared to a normative healthy population, long-term stroke survivors reported poorer sleep and greater daytime sleepiness. Increased levels of sleepiness were associated with longer chronicity, whereas nocturnal sleep parameters were not. Conclusions: In line with clinical observations, stroke survivors with sustained physical disabilities report poorer sleep and experience greater levels of sleepiness. Further research in a larger cohort and including objective sleep measures is necessary to investigate the nature and scale of sleep difficulties and daytime sleepiness in more detail so that care and treatment strategies can be developed in due course

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Self-Reported Changes to Nighttime Sleep After Traumatic Brain Injury

Cited by 133 publications

References 54 publications

Sleep Disturbances in Traumatic Brain Injury: A Meta-Analysis

Sleep Disturbances in Traumatic Brain Injury: A Meta-Analysis

Sleep, Sleep Disorders, and Mild Traumatic Brain Injury. What We Know and What We Need to Know: Findings from a National Working Group

Time to wake-up: Sleep problems and daytime sleepiness in long-term stroke survivors

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