Impact of post-traumatic hypersomnia on functional recovery of cognition and communication

Abstract

Primary objective: To assess aspects of cognition and communication, in response to the treatment of post-traumatic hypersomnia and mood disturbance.

Research design: A single case study; pre–post intervention.

Methods and procedures: The participant was a male with severe TBI and cognitive-communication impairments, who subsequently developed sleep and mood disturbance and excessive daytime sleepiness. The Daily Cognitive-Communication and Sleep Profile (D-CCASP), Clinical Interview, Epworth and Stanford Sleepiness Scales and polysomnography assessed sleep and wakefulness. Cognitive-communication was also assessed by the D-CCASP. His sleep, wake and mood difficulties were pharmacologically managed.

Main outcomes and results: Baseline polysomnography indicated abnormal sleep. There was a clear positive relationship between quality of sleep, language processing, attention and memory, seen across the phases of the medication intervention (p < 0.01).

Conclusions: A comprehensive pharmacological management programme addressing the multi-factorial underlying aetiology was successful in improving sleep, arousal and mood. The D-CCASP was found to be clinically and statistically sensitive to reported changes in cognitive-communication function in relation to improvements in sleep and daytime arousal. These findings suggest that management of sleep/wake disturbances and mood post-traumatic brain injury can potentially facilitate improvements in cognitive-communication function which may, in turn, facilitate participation in rehabilitation and community integration.

• Sleep disturbance
• hypersomnia
• excessive day-time sleepiness
• traumatic brain injury
• cognition
• cognitive-communication
• mood disturbance