Research Reports - Characterizing self-reported sleep disturbance following mild traumatic brain injury

J Neurotrauma. 2014 Oct 2

Sullivan K(1), Edmed S, Allan AC, Karlsson LJ, Smith SS

Sleep disturbance following mTBI is commonly reported as debilitating and
persistent. However, the nature of this disturbance is poorly understood. This
study sought to characterize sleep following mTBI compared to a control group. A
cross-sectional matched case control design was used. Thirty-three individuals
with recent mTBI (1-6 months ago) and 33 age, gender, and ethnicity matched
controls completed established questionnaires of sleep quality, quantity, timing,
and sleep-related daytime impairment. MTBI participants were compared to an
independent sample of close-matched controls (CMCs; n = 33) to allow partial
internal replication. Compared to controls, people with mTBI reported
significantly greater sleep disturbance, more severe insomnia symptoms, a longer
duration of wake after sleep onset (WASO), and greater sleep-related impairment
(all medium to large effects, Cohen's d >0.5). No differences were found in sleep
quantity, timing, sleep onset latency, sleep efficiency or daytime sleepiness.
All findings except a measure of sleep timing (i.e., sleep midpoint) were
replicated for CMCs. These results indicate a difference in the magnitude and
nature of perceived sleep disturbance following mTBI compared with controls,
where people with mTBI report poorer sleep quality and greater impairment from
their sleep. The finding that other sleep parameters did not differ has
implications for treatment. These findings should guide the provision of clearer
advice to patients about the aspects of their sleep that may change following
mTBI and which treatments may be suitable.

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