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Cited by 334Sleep and related disordersTraumatic Brain Injury ResearchObstructive Sleep Apnea Research

Prevalence and Consequences of Sleep Disorders in Traumatic Brain Injury

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Castriotta, Richard J., Wilde, Mark C., Lai, Jenny M., Atanasov, Strahil, Masel, Brent E., Kuna, Samuel T.·2007·Journal of Clinical Sleep Medicine
DOI 10.5664/jcsm.26855PMC PMC1978308
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Abstract

Study objectives Determine prevalence and consequences of sleepiness and sleep disorders after traumatic brain injury (TBI). Methods Prospective evaluation with polysomnography (PSG), multiple sleep latency test (MSLT), Epworth Sleepiness Scale (ESS) and neuropsychological testing including Psychomotor Vigilance Test (PVT), Profile of Mood States (POMS), and Functional Outcome of Sleep Questionnaire (FOSQ). Setting Three academic medical centers with level I trauma centers, accredited sleep disorders centers, and rehabilitative medicine programs. Participants; Eighty-seven (87) adults at least 3 months post TBI. Measurements and results Abnormal sleep studies were found in 40 subjects (46%), including 20 (23%) with obstructive sleep apnea (OSA), 10 (11%) with posttraumatic hypersomnia (PTH), 5 (6%) with narcolepsy, and 6 (7%) with periodic limb movements in sleep (PLMS). Among all subjects, 22 (25%) were found to have objective excessive daytime sleepiness with MSLT score <10 minutes. There was no correlation between ESS score and MSLT (r = 0.10). There were no differences in age, race, sex, or education between the sleepy and non-sleepy subjects. Likewise, there were no differences in severity of injury or time after injury between sleepy and non-sleepy subjects. Sleepy subjects had a greater body mass index (BMI) than those who were not sleepy (p = 0.01). OSA was more common in obese subjects (BMI > or =30, p < 0.001). Sleepy subjects demonstrated poorer PVT scores (p < 0.05), better self-reported sleep related quality of life (FOSQ scores [p < 0.05]), and no differences in POMS. Conclusions There is a high prevalence of sleep disorders (46%) and of excessive daytime sleepiness (25%) in subjects with TBI. Sleepy subjects may be more impaired than comparable non-sleepy TBI subjects, yet be unaware of problems. Given the high prevalence of OSA (23%), PTH (11%), and narcolepsy (7%) in this population, there is a clinical indication for NPSG and MSLT.

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  • Chronic daytime sleepiness is a major disabling symptom for many patients with TBI, and its etiology is not well understood.

    “Chronic, daytime sleepiness is a major, disabling symptom for many patients with traumatic brain injury (TBI), but thus far, its etiology is not well understood.”

    From Loss of hypocretin (orexin) neurons with traumatic brain injury (2009) · cites this paper as [3]

    The Discussion reports a high prevalence of excessive daytime sleepiness after TBI and poorer cognitive and vigilance performance in sleepy subjects. It says functional disability is possible but that the impact on day-to-day functioning has not been established; it also cannot determine whether some sleep disorders preceded the injury. The paper therefore supports the prevalence and uncertainty about cause, but not the stronger claim that chronic sleepiness is an established major disabling symptom. (LLM, conf=0.85)

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  • Even after 6 months recovery, 43% of patients have symptoms of sleep disorders.

    “Coma and obtundation are common during the acute period, but even after 6 months recovery, 43% of patients have symptoms of sleep disorders.2,3”

    From Loss of hypocretin (orexin) neurons with traumatic brain injury (2009) · cites this paper as [3]

    The Discussion reports that 47% of the TBI sample had a diagnosed sleep disorder, and Table 4 includes patients studied more than six months after injury. It does not report that 43% had symptoms after six months of recovery; the stated percentage, measure, and time-specific estimate are unsupported. (LLM, conf=0.84)

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  • In another study of 87 patients, sleepiness occurred in 25% after TBI.

    “Another study of 87 patients revealed similar results, with sleepiness in 25% after TBI.3”

    From Loss of hypocretin (orexin) neurons with traumatic brain injury (2009) · cites this paper as [3]

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5 of the 48 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Levin HS. Head trauma. Curr Opin Neurol 1993;6:841-6.
  2. Williams DH, Levin HS, Eisenberg HM. Mild head injury classifi- cation. Neurosurgery 1990;27:422-8.

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Authors
Castriotta, R. J., Wilde, M. C., Lai, J. M., Atanasov, S., Masel, B. E., & Kuna, S. T.
Affiliations
  • Memorial Hermann (US)
  • The University of Texas Medical Branch at Galveston (US)
  • Transitional Learning Center (US)
  • Philadelphia VA Medical Center (US)
ORCID
Venue
Journal of Clinical Sleep Medicine
Publisher
Springer Science and Business Media LLC
Published
2007-06-15
Volume
3
Issue
4
Pages
349-356
ISSN
  • 1550-9389 (ISSN-L)
  • 1550-9397
DOI
10.5664/jcsm.26855
PMC
PMC1978308
OpenAlex
W1962631311
Cited by
334
References
48
Citations by year
2026: 8 · 2025: 18 · 2024: 8 · 2023: 10 · 2022: 21 · 2021: 19 · 2020: 20 · 2019: 19 · 2018: 28 · 2017: 11 · 2016: 22 · 2015: 27 · 2014: 20 · 2013: 32 · 2012: 19
FWCI
17.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Sleep Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Moody Foundation
  • Pfizer
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Keywords
traumatic brain injury, sleep disorders, excessive daytime sleepiness, obstructive sleep apnea, narcolepsy, periodic limb movements in sleep, sleep quality, body mass index, obesity, polysomnography, multiple sleep latency test, Epworth Sleepiness Scale, psychomotor vigilance test, Profile of Mood States, neuropsychological deficits
MeSH terms
Adult, Affect, Brain Injuries, Cognition, Female, Humans, Disorders of Excessive Somnolence, Male, Narcolepsy, Neuropsychological Tests, Obesity, Prospective Studies, Psychomotor Performance, Quality of Life, Surveys and Questionnaires, Sleep Apnea Syndromes, Sleep Wake Disorders, Trauma Severity Indices, Comorbidity, Body Mass Index, Prevalence, Polysomnography

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