Sleep disturbance and length of stay in the setting of acquired brain injury rehabilitation

ABSTRACT

Objective

The objective of this study was to investigate the impact and prevalence of sleep-wake disturbances among adult patients admitted for inpatient acquired brain injury rehabilitation.

Method

This was a retrospective cohort study involving all adults admitted for inpatient ABI neurocognitive rehabilitation at UHN-Toronto Rehabilitation Institute over a 12-month period (n = 165). The primary endpoint of the study was the comparison of functional independent measure efficiency and hospital length of stay between patients reporting sleep disturbance (e.g. increased sleep latency, obstructive sleep apnea [OSA], sleep maintenance insomnia) versus those with normal sleep.

Results

We found that more than half (58.2%) of patients experienced sleep disturbance based on a combination of self-report and clinical documentation. The most common sleep disturbance was increased sleep onset latency (28.5%), followed by mixed sleep onset/maintenance insomnia (14.5%) and obstructive sleep apnea (8.5%). Notably, OSA was associated with longer length of hospital stay and reduced functional independence measure (FIM) efficiency in the cognitive domain after accounting for age and number of medical comorbidities.

Implications

The results of this investigation underscore the importance of screening patients with brain injury for sleep disturbances due to its high prevalence and impact on rehabilitation efficiency.

KEYWORDS:

• Neurorehabilitation
• acquired brain injury
• obstructive sleep apnea
• sleep disturbance
• length of stay

Disclosure statement

The authors report no conflicts of interest.

Author contribution

AD and MG contributed to the planning and design of the study, analysis of the data and writing of the manuscript. AK, AT and MB contributed to the planning and design of the study, data collection and writing of the manuscript.