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Prevalence and Consequences of Sleep Disorders in Traumatic Brain Injury
Open accessAbstract
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 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]
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“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]
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“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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Metadata
- 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)
- Venue
- Journal of Clinical Sleep Medicine
- Published
- 2007-06-15
- Volume
- 3
- Issue
- 4
- Pages
- 349-356
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- 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
- bronze
- doi.org
- 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 › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Physiology (medical) › 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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