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

J Neurotrauma. 2015 Apr 1;32(7):474-86

Sullivan KA(1), Edmed SL, Allan AC, Karlsson LJ, Smith SS

Sleep disturbance after mild traumatic brain injury (mTBI) is commonly reported
as debilitating and persistent. However, the nature of this disturbance is poorly
understood. This study sought to characterize sleep after mTBI compared with a
control group. A cross-sectional matched case control design was used.
Thirty-three persons with recent mTBI (1-6 months ago) and 33 age, sex, and
ethnicity matched controls completed established questionnaires of sleep quality,
quantity, timing, and sleep-related daytime impairment. The mTBI participants
were compared with an independent sample of close-matched controls (CMCs; n=33)
to allow partial internal replication. Compared with controls, persons with mTBI
reported significantly greater sleep disturbance, more severe insomnia symptoms,
a longer duration of wake after sleep onset, 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 after mTBI compared with controls, where
persons with mTBI report poorer sleep quality and greater sleep-related
impairment. Sleep quantity and timing did not differ between the groups. These
preliminary findings should guide the provision of clearer advice to patients
about the aspects of their sleep that may change after mTBI and could inform
treatment selection.

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