Research Reports - The impact of poor sleep on cognition and activities of daily living after traumatic brain injury

Aust Occup Ther J. 2015 Feb;62(1):2-12

Duclos C(1), Beauregard MP, Bottari C, Ouellet MC, Gosselin N

BACKGROUND/AIM: Patients frequently report sleep disruptions or insomnia during
their hospital stay, particularly after a traumatic brain injury (TBI). The
consequences of these sleep disturbances on everyday activities are not well
documented and are therefore not considered in the evaluation of independence in
activities of daily living (ADLs). The goal of this narrative review is to
explore the consequences of poor sleep quality on cognition and ADLs in the acute
and subacute stages of a moderate and severe TBI, when patients are in acute care
or inpatient rehabilitation.
METHODS: We will present an overview of normal sleep and its role in cognitive
functioning, and then present the findings of studies that have investigated
sleep characteristics in hospital settings and the consequences of sleep
disturbances on ADLs.
RESULTS: During hospitalisation, TBI patients present severe sleep disturbances
such as insomnia and sleep fragmentation, which are probably influenced by both
the medical condition and the hospital or rehabilitation environment. Sleep
disruption is associated with several cognitive deficits, including attention,
memory and executive function impairments. Poor quality and/or insufficient
quantity of sleep in acute TBI probably affect general functioning and ADLs
calling for these cognitive functions.
CONCLUSIONS AND SIGNIFICANCE: The cognitive impairments present following TBI are
probably exacerbated by poor sleep quality and sleep deprivation during
hospitalisation, which in turn impact ADLs among this population. Health-care
personnel should further consider sleep disturbances among people with TBI and a
sleep protocol should be established.

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