Evaluation of sleep disorders in patients with severe traumatic brain injury during rehabilitation

Gardani, M. , Morfiri, E., Thomson, A., O’Neill, B. and McMillan, T. M. (2015) Evaluation of sleep disorders in patients with severe traumatic brain injury during rehabilitation. Archives of Physical Medicine and Rehabilitation, 96(9), 1691-1697.e3. (doi: 10.1016/j.apmr.2015.05.006) (PMID:26003285)

Abstract

Objective: To explore the presence and types of sleep disorders in chronic patients with severe traumatic brain injury (TBI) undergoing inpatient rehabilitation using formal diagnostic criteria based on the International Classification of Sleep Disorders (2nd edition). Design: Cross sectional study. Setting: Inpatient brain injury rehabilitation units (UK). Participants: Thirty (n=30) chronic inpatients with severe TBI were evaluated during rehabilitation. Interventions: None. Main Outcome Measures: Participants wore an actiwatch for seven days and completed self-report measures on sleep, mood, fatigue, pain and daytime sleepiness. Results: Twenty participants (67%) had sleep-wake cycle disturbances (SWCD), of which fifteen (50%) met diagnostic criteria for a sleep disorder. Diagnosed sleep disorders in the sample were insomnia (26.7%), post-traumatic hypersomnia (6.7%), delayed sleep phase syndrome (10%), irregular sleep-wake pattern disorder (3.3%) and periodic limb movement disorder (3.3%). Sleep quality was estimated by senior clinical staff as interfering with rehabilitation in 36.6% of the sample. Poor sleep quality was associated with greater anxiety, fatigue, and daytime sleepiness. Conclusions: Consistent with previous studies, the present investigation showed high levels of disturbed sleep-wake cycle disturbances in rehabilitation patients with severe TBI and this was associated with anxiety, fatigue, and daytime sleepiness. These findings highlight the importance of assessing and treating sleep problems in patients with TBI undergoing rehabilitation.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gardani, Dr Maria and McMillan, Professor Tom
• Authors: Gardani, M., Morfiri, E., Thomson, A., O’Neill, B., and McMillan, T. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Science and Engineering > School of Psychology
• Journal Name: Archives of Physical Medicine and Rehabilitation
• Publisher: Elsevier Inc.
• ISSN: 0003-9993