The Effect of Traumatic Brain Injury on the Timing of Sleep

ArticleinChronobiology International 22(1):89-105 · February 2005with9 Reads
DOI: 10.1081/CBI-200042428 · Source: PubMed
While there have been single case reports of the development of circadian rhythm sleep disorders, most commonly delayed sleep phase syndrome following traumatic brain injury (TBI), to our knowledge there have been no group investigations of changes to sleep timing in this population. The aim of the present study was to investigate sleep timing following TBI using the dim light melatonin onset (DLMO) as a marker of circadian phase and the Morningness-Eveningness Questionnaire (MEQ) as a measure of sleep-wake behavior. A sleep-wake diary was also completed. It was hypothesized that the timing of DLMO would be delayed and that there would be a greater tendency toward eveningness on the MEQ in a post-acute TBI group (n=10) compared to a gender and age matched control group. Participants were recruited at routine outpatient review appointments (TBI) and from the general population (control) as part of a larger study. They attended the sleep laboratory where questionnaires were completed, some retrospectively, and saliva melatonin samples were collected half-hourly according to a standard protocol. The results show that the TBI and control groups reported similar habitual sleep times and this was reflected on the MEQ. There was, however, significant variability in the TBI group's change from the pre-injury to the current MEQ score. The timing of melatonin onset was not different between the groups. While subtle changes (advances or delays) in this small sample may have cancelled each other out,. the present study does not provide conclusive objective evidence of shift in circadian timing of sleep following TBI. Furthermore, although participants did report sleep timing changes, it is concluded that the MEQ may not be suitable for use with this cognitively impaired clinical group.
    • "Original article 77 similar to those experienced by children with sleep disturbances (Beebe et al., 2007; Milroy et al., 2008). Among adults, sleep disturbances have been reported in 30–70% of individuals after TBI (Orff et al., 2009), and usually involve problems initiating and/or maintaining sleep (Steele et al., 2005; Baumann et al., 2007; Kempf et al., 2010; Shekleton et al., 2010). There have also been reports of higher prevalence of sleep disorders including narcolepsy, insomnia, sleep apnoea, hypersomnia and periodic limb movements (Castriotta and Lai, 2001; Castriotta et al., 2007; Verma et al., 2007; Castriotta and Murthy, 2011). "
    [Show abstract] [Hide abstract] ABSTRACT: Sleep is often disrupted in traumatic brain injury (TBI) and may be related to persistent behaviour problems; however, little is known about this relationship in young adults. This study explored associations between TBI, behavioural problems and sleep disturbances in 247 university students (197 non-TBI, 47 mild TBI, two moderate TBI, one severe TBI) aged 18–25 years, who completed validated measures for behaviour, sleep quality and history of TBI. Because of small group numbers, participants reporting moderate to severe TBI were excluded from the analyses. Results indicated that students with mild TBI reported higher levels of daytime dysfunction, somatic complaints, withdrawal, other behavioural complaints and internalizing behaviours compared with students with no TBI history. A correlational analysis indicated a moderate relationship between the above significant variables. Our results suggest that university students with a history of mild TBI are more likely to experience certain ongoing daytime behavioural problems, which are likely to negatively influence their academic functioning in tertiary education. This study highlights the importance of research on long-term problems following mild TBI in young adults aged 18–25 years – an age group often overlooked within the literature.
    Article · Dec 2015
    • "Alterations in daily rhythms have also been found in chronic moderate and severe TBI, where patients showed decreased evening melatonin production [44,67]. Decreased melatonin secretion, however, was not found in another study performed in 10 TBI patients 516 AE 124.04 days post-injury and 10 age-and sex-matched controls [68]. Moreover, the immune response triggered by the TBI itself, and possibly other injuries that may accompany it, could contribute to circadian dysregulation following injury. "
    [Show abstract] [Hide abstract] ABSTRACT: L’occurrence d’un traumatisme craniocérébral (TCC) est un problème de santé publique majeure. Les troubles du sommeil et de l’éveil sont parmi les symptômes les plus persistants et les plus déshabilitants à la suite d’un TCC. Or, les études empiriques portant sur l’apparition de ces symptômes, leur chronicisation et leur traitement demeurent non concluantes. Cette revue narrative a comme but de recenser le niveau de connaissance actuel sur la nature (objective et subjective) des troubles du sommeil et de l’éveil chez les patients TCC, en tenant compte de la sévérité du traumatisme et de la phase de rétablissement. Un but secondaire est de cibler les causes potentielles de ses perturbations. En général, bien que la présence de troubles du sommeil et de l’éveil dans toutes les études conduites auprès de patients TCC soit observée indépendamment de la sévérité du traumatisme, des signes objectivables de la présence de telles perturbations ne sont pas rapportés de façon consistante dans ces études. Des études supplémentaires semblent être requises afin de mieux comprendre la complexité des troubles du sommeil et de l’éveil chez les patients TCC et d’optimiser la récupération à court et à long terme chez cette clientèle par l’entremise d’interventions ciblées.
    Full-text · Article · Oct 2014
    • ". Many of these disorders are sufficiently burdensome after TBI [19]. Specifically, this applies to insomnias [20] [21], sleep-related breathing disorders (SRBD) [22], hypersomnia not due to breathing disorders [3] [23], circadian rhythm sleep disorders (CRSD) [24] [25] [26], sleep-related movement disorders [27], and other sleep disorders [28] "
    [Show abstract] [Hide abstract] ABSTRACT: Numerous studies on the high prevalence of sleep disorders in individuals with traumatic brain injury (TBI) have been conducted in the past few decades. These disorders can accentuate other consequences of TBI, negatively impacting mood, exacerbating pain, heightening irritability, and diminishing cognitive abilities and the potential for recovery. Nevertheless, sleep is not routinely assessed in this population. In our review, we examined the selective screening criteria and the scientific evidence regarding screening for post-TBI sleep disorders to identify gaps in our knowledge that are in need of resolution. We retrieved papers written in the English-language literature before June 2012 pertinent to the discussion on sleep after TBI found through a PubMed search. Within our research, we found that sleep dysfunction is highly burdensome after TBI, treatment interventions for some sleep disorders result in favorable outcomes, sensitive and specific tests to detect sleep disorders are available, and the cost-effectiveness and sustainability of screening have been determined from other populations. The evidence we reviewed supports screening for post-TBI sleep dysfunction. This approach could improve the outcomes and reduce the risks for post-TBI adverse health and nonhealth effects (e.g., secondary injuries). A joint sleep and brain injury collaboration focusing on outcomes is needed to improve our knowledge.
    Full-text · Article · Sep 2013
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