Increased short- and long-term risk of sleep disorders in people with traumatic brain injury

ABSTRACT

This study aims to evaluate the relationship between traumatic brain injury (TBI) and sleep disorders (SDs). We first initiated a questionnaire-based clinical survey to assess sleep problems in the early stage after a TBI, followed by a population-based cohort study to evaluate the long-term risk of SDs in TBI patients. For short-term clinical survey, mild (m)TBI patients and healthy controls were recruited to evaluate the sleep quality and daytime sleepiness using the Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) within two weeks after a TBI. For long-term observation, a 5-year nationwide population-based cohort study that utilized a large administrative database was conducted. In the short-term survey, 236 mTBI patients and 223 controls were analyzed. Total scores of the PSQI and ESS were significantly higher in mTBI patients than in the controls. In the long-term cohort study, 6932 TBI cases and 34,660 matched controls were included. TBI cases had a 1.36-fold greater risk of SDs compared to the non-TBI controls during the 5-year follow-up period. Results showed that patients with TBI had a significantly higher risk of SDs than did controls both in the early stage and during a 5-year follow-up period.

KEYWORDS:

• Traumatic brain injury
• Sleep quality
• Sleep disorders
• Nationwide population-based cohort study

Authors’ contributions

YJW: implementation of experiments, analysis and interpretation of data, and drafting of the manuscript. WCC: analysis and interpretation of data and drafting of the manuscript. CCW: data acquisition and drafting of the manuscript. YHC and WTC: analysis and interpretation of data and revising the manuscript critically for important intellectual content. KYC and WPC: study concept and design, analysis and interpretation of data, drafting of the manuscript, and supervising the work. All authors read and approved the final manuscript.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval and consent to participate

This study was approved by the Taipei Medical University-Joint Institutional Review Board (TMU-JIRB) (no.: P980803, 201003008, and 201309033).

Additional information

Funding

This work was supported by the Ministry of Science and Technology, Taiwan [grant number NSC 98-2321-B-038-003-MY3, MOST 108-2314-B-038-062]; Department of Taiwan Food and Drug Administration [grant number MOHW108-FDA-113-000005]; Bureau of Taipei City Health [grant number 10832]; Higher Education Sprout Project of the Ministry of Education in Taiwan [grant number DP2-107-21121-A-05]; and Taipei Medical University [grant number DP2-108-21121-01-N-05-01].