Catherine Duclos1, Marie Dumont1, Hélène Blais2, Jean Paquet2, Elyse Laflamme2, Louis de Beaumont3, Catherine Wiseman-Hakes1, David K Menon4, Francis Bernard1, Nadia Gosselin5. 1. Hôpital du Sacré-Coeur de Montréal, Montréal, Canada Université de Montréal, Montréal, Canada. 2. Hôpital du Sacré-Coeur de Montréal, Montréal, Canada. 3. Hôpital du Sacré-Coeur de Montréal, Montréal, Canada Université du Québec à Trois-Rivières, Trois-Rivières, Canada. 4. University of Cambridge, Cambridge, UK. 5. Hôpital du Sacré-Coeur de Montréal, Montréal, Canada Université de Montréal, Montréal, Canada nadia.gosselin@umontreal.ca.
Abstract
BACKGROUND: Sleep-wake disturbances are among the most persistent sequelae after traumatic brain injury (TBI) and probably arise during the hospital stay following TBI. These disturbances are characterized by difficulties sleeping at night and staying awake during the day. OBJECTIVE: The aim of the present study was to document rest-activity cycle consolidation in acute moderate/severe TBI using actigraphy and to assess its association with injury severity and outcome. METHODS: In all, 16 hospitalized patients (27.1 ± 11.3 years) with moderate/severe TBI wore actigraphs for 10 days, starting in the intensive care unit (ICU) when continuous sedation was discontinued and patients had reached medical stability. Activity counts were summed for daytime (7:00-21:59 hours) and nighttime periods (22:00-6:59 hours). The ratio of daytime period activity to total 24-hour activity was used to quantify rest-activity cycle consolidation. An analysis of variance was carried out to characterize the evolution of the daytime activity ratio over the recording period. RESULTS: Rest-activity cycle was consolidated only 46.6% of all days; however, a significant linear trend of improvement was observed over time. Greater TBI severity and longer ICU and hospital lengths of stay were associated with poorer rest-activity cycle consolidation and evolution. Patients with more rapid return to consolidated rest-activity cycle were more likely to have cleared posttraumatic amnesia and have lower disability at hospital discharge. CONCLUSIONS: Patients with acute moderate/severe TBI had an altered rest-activity cycle, probably reflecting severe fragmentation of sleep and wake episodes, which globally improved over time. A faster return to rest-activity cycle consolidation may predict enhanced brain recovery.
BACKGROUND:Sleep-wake disturbances are among the most persistent sequelae after traumatic brain injury (TBI) and probably arise during the hospital stay following TBI. These disturbances are characterized by difficulties sleeping at night and staying awake during the day. OBJECTIVE: The aim of the present study was to document rest-activity cycle consolidation in acute moderate/severe TBI using actigraphy and to assess its association with injury severity and outcome. METHODS: In all, 16 hospitalized patients (27.1 ± 11.3 years) with moderate/severe TBI wore actigraphs for 10 days, starting in the intensive care unit (ICU) when continuous sedation was discontinued and patients had reached medical stability. Activity counts were summed for daytime (7:00-21:59 hours) and nighttime periods (22:00-6:59 hours). The ratio of daytime period activity to total 24-hour activity was used to quantify rest-activity cycle consolidation. An analysis of variance was carried out to characterize the evolution of the daytime activity ratio over the recording period. RESULTS: Rest-activity cycle was consolidated only 46.6% of all days; however, a significant linear trend of improvement was observed over time. Greater TBI severity and longer ICU and hospital lengths of stay were associated with poorer rest-activity cycle consolidation and evolution. Patients with more rapid return to consolidated rest-activity cycle were more likely to have cleared posttraumatic amnesia and have lower disability at hospital discharge. CONCLUSIONS:Patients with acute moderate/severe TBI had an altered rest-activity cycle, probably reflecting severe fragmentation of sleep and wake episodes, which globally improved over time. A faster return to rest-activity cycle consolidation may predict enhanced brain recovery.
Authors: Catherine Duclos; Marie Dumont; Caroline Arbour; Jean Paquet; Hélène Blais; David K Menon; Louis De Beaumont; Francis Bernard; Nadia Gosselin Journal: Neurology Date: 2016-12-21 Impact factor: 9.910
Authors: Sapna R Kudchadkar; Othman Aljohani; Jordan Johns; Andrew Leroux; Eman Alsafi; Ebaa Jastaniah; Allan Gottschalk; Nehal J Shata; Ahmad Al-Harbi; Daniel Gergen; Anisha Nadkarni; Ciprian Crainiceanu Journal: J Pediatr Date: 2019-03-15 Impact factor: 4.406
Authors: Catherine Duclos; Marie Dumont; Jean Paquet; Hélène Blais; Solenne Van der Maren; David K Menon; Francis Bernard; Nadia Gosselin Journal: Sleep Date: 2020-01-13 Impact factor: 5.849
Authors: David A Kalmbach; Deirdre A Conroy; Hayley Falk; Vani Rao; Durga Roy; Matthew E Peters; Timothy E Van Meter; Frederick K Korley Journal: Sleep Date: 2018-10-01 Impact factor: 5.849
Authors: Julien Lauzier Bigué; Catherine Duclos; Marie Dumont; Jean Paquet; Hélène Blais; David K Menon; Francis Bernard; Nadia Gosselin Journal: J Clin Sleep Med Date: 2020-01-13 Impact factor: 4.062
Authors: Stuti J Jaiswal; Thomas J McCarthy; Nathan E Wineinger; Dae Y Kang; Janet Song; Solana Garcia; Christoffel J van Niekerk; Cathy Y Lu; Melissa Loeks; Robert L Owens Journal: Am J Med Date: 2018-05-03 Impact factor: 4.965