Research Reports - Sleepiness and fatigue following traumatic brain injury

Sleep Med. 2012 Jun;13(6):598-605

Beaulieu-Bonneau S, Morin CM

OBJECTIVES: To compare individuals with traumatic brain injury (TBI) to healthy
controls (CTLs) on measures of sleepiness, fatigue, and sleep, and explore
correlates of sleepiness and fatigue separately for each group.
METHODS: Participants were 22 adults with moderate/severe TBI (time since injury
⩾1 year; mean=53.0±37.1months) and 22 matched healthy CTLs. They underwent one
night of polysomnographic (PSG) recording of their sleep followed the next day by
the Maintenance of Wakefulness Test (MWT). They also completed a 14-day sleep
diary, the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep
Questionnaire (FOSQ), and the Multidimensional Fatigue Inventory (MFI).
RESULTS: There were no significant group differences on measures of objective
(MWT) or subjective (ESS) sleepiness, both groups being quite alert. However, TBI
participants reported greater consequences of sleepiness on their general
productivity (FOSQ), spent more time in bed at night, and napped more frequently
and for a longer time during the day. Subjective fatigue was significantly higher
in TBI participants on the general, physical, and mental fatigue MFI subscales.
There were no between-group differences on any sleep parameters derived either
from PSG or sleep diary.
CONCLUSIONS: Fatigue appeared to be a more prominent symptom than sleepiness when
assessed between 1 and 11 years after TBI. Participants with TBI used
compensatory strategies such as increasing time spent in bed and daytime napping
in this sample. Future research should document the time course of sleepiness and
fatigue after TBI and investigate treatment options.

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