Correlates of persistent sleep complaints after traumatic brain injury

Abstract

The objective of the study was to examine factors associated with persistent sleep complaint (SC) after traumatic brain injury. The study design consisted of a retrospective chart review case series, with longitudinal follow-up data. Subjects were identified from Georgia Model Brain Injury System with sleep data post-injury. Twenty three (47.9%) had no sleep complaint at either 6 or 12 months post-injury or resolved sleep complaint at 12 months (Without Persistent SC group); 25 (52.1%) maintained a sleep complaint from 6 to 12 months or reported a sleep complaint at 12 months post-injury (With Persistent SC group). Demographic, premorbid and peri-injury characteristics and The Neurobehavioral Functioning Inventory (NFI) scores did not differentiate the two groups. The Without Persistent SC group had a slight improvement from 6 to 12 months post-injury in post-traumatic stress (PTS) symptoms and depression. Significant psychological patterns were identified in those with persistent SC at both 6 and 12 months post-injury, i.e., worse depression and worse PTS symptoms. This trend was apparent at 6 months and became significant at 12 months post-injury. However, subjects with newly emerging sleep complaints at 12 months had similar characteristics as the Without Persistent SC group. The observed psychological patterns associated with persistent sleep complaint in a specific time course after brain injury have important research and clinical implications that merit further study.

Keywords:

• Traumatic brain injury
• Sleep
• Post-traumatic stress
• Depression

Acknowledgments

The work was supported in part by US Department of Veterans Affairs Rehabilitation Research and Development Career Development Award Level II (WH) (B6924W). The TBI Model Systems National Database was funded by a grant from the US Department of Education, National Institute on Disability and Rehabilitation Research (NIDRR) in collaboration with the TBI Model Systems Centers. The contents of the manuscript do not necessarily reflect the opinions or views of the TBI Model Systems Centers, NIDRR or the US Department of Education.

The authors would like to thank Megan Denham and Rachel Wolf for their assistance with data entry and database management.