Research Reports - Exploring the experience of sleep and fatigue in male and female adults over the 2 years following traumatic brain injury

BMJ Open. 2016 Apr 8;6(4):e010453. doi: 10.1136/bmjopen-2015-010453.

Theadom A(1), Rowland V(1), Levack W(2), Starkey N(3), Wilkinson-Meyers L(4),
McPherson K(5); TBI Experiences Group.

OBJECTIVES: To explore the experience of fatigue and sleep difficulties over the
first 2 years after traumatic brain injury (TBI).
DESIGN: Longitudinal qualitative descriptive analysis of interviews completed as
part of a larger longitudinal study of recovery following TBI. Data relating to
the experience of fatigue and/or sleep were extracted and coded by two
independent researchers.
SETTING: Community-based study in the Hamilton and Auckland regions of New
Zealand.
PARTICIPANTS: 30 adult participants who had experienced mild, moderate or severe
brain injury within the past 6 months (>16 years of age). 15 participants also
nominated significant others to take part. Interviews were completed at 6, 12 and
24 months postinjury.
RESULTS: Participants described feeling unprepared for the intensity, impact and
persistent nature of fatigue and sleep difficulties after injury. They struggled
to learn how to manage their difficulties by themselves and to adapt strategies
in response to changing circumstances over time. Four themes were identified: (1)
Making sense of fatigue and sleep after TBI; (2) accepting the need for rest; (3)
learning how to rest and; (4) need for rest impacts on ability to engage in life.
CONCLUSIONS: Targeted support to understand, accept and manage the sleep and
fatigue difficulties experienced may be crucial to improve recovery and
facilitate engagement in everyday life. Advice needs to be timely and revised for
relevance over the course of recovery. 

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