Lai Gwen Chan1, Anthony Feinstein. 1. Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Dr Chan), and, Department of Psychological Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore (Dr Chan); and Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Dr Feinstein).
Abstract
OBJECTIVE: To investigate the effect of sleep disturbances on functional and social outcomes after mild traumatic brain injury. SETTING: Outpatient traumatic brain injury clinic in a tertiary trauma center. PARTICIPANTS: A total of 374 mild traumatic brain injury patients were assessed within 3 months of injury and followed up every 3 months for 1 year. DESIGN: Analysis of a historical cohort in a naturalistic clinical setting. MAIN MEASURES: At each visit, symptoms of concussion and psychological distress and indices of functional and social outcomes were measured with the Rivermead Postconcussion Questionnaire, 28-item General Health Questionnaire, and Rivermead Head Injury Follow-up Questionnaire, respectively. Changes in outcome scores over time were explored using repeated measures analysis of variance and compared between subjects with persistent (SD) and recovered (SR) sleep disturbances. Predictors of functional/social outcome were determined using linear regression. RESULTS: The percentages of subjects reporting sleep disturbances at each time point were 71.9%, 57.2%, 55.1%, and 53.7%, respectively. For functional and social outcomes, significant effects of time (F3,315 = 9.54; P < .001), group (SD vs SR) F1,317 = 5.32; P = .022, and time X group interaction F3,315 = 4.14; P = .007 were found. Persistent sleep disturbance (P = 0.011) and higher symptom burden at 6 months postinjury (P < .0001) were independent predictors of poorer outcome. CONCLUSION: Sleep disturbance, independent of psychological distress, is an important prognostic factor of functional and social outcomes after mild traumatic brain injury.
OBJECTIVE: To investigate the effect of sleep disturbances on functional and social outcomes after mild traumatic brain injury. SETTING:Outpatienttraumatic brain injury clinic in a tertiary trauma center. PARTICIPANTS: A total of 374 mild traumatic brain injurypatients were assessed within 3 months of injury and followed up every 3 months for 1 year. DESIGN: Analysis of a historical cohort in a naturalistic clinical setting. MAIN MEASURES: At each visit, symptoms of concussion and psychological distress and indices of functional and social outcomes were measured with the Rivermead Postconcussion Questionnaire, 28-item General Health Questionnaire, and Rivermead Head Injury Follow-up Questionnaire, respectively. Changes in outcome scores over time were explored using repeated measures analysis of variance and compared between subjects with persistent (SD) and recovered (SR) sleep disturbances. Predictors of functional/social outcome were determined using linear regression. RESULTS: The percentages of subjects reporting sleep disturbances at each time point were 71.9%, 57.2%, 55.1%, and 53.7%, respectively. For functional and social outcomes, significant effects of time (F3,315 = 9.54; P < .001), group (SD vs SR) F1,317 = 5.32; P = .022, and time X group interaction F3,315 = 4.14; P = .007 were found. Persistent sleep disturbance (P = 0.011) and higher symptom burden at 6 months postinjury (P < .0001) were independent predictors of poorer outcome. CONCLUSION: Sleep disturbance, independent of psychological distress, is an important prognostic factor of functional and social outcomes after mild traumatic brain injury.
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: Danielle K Sandsmark; Monisha A Kumar; Catherine S Woodward; Sarah E Schmitt; Soojin Park; Miranda M Lim Journal: J Head Trauma Rehabil Date: 2016 Mar-Apr Impact factor: 2.710
Authors: Lindsay D Nelson; Robyn E Furger; Jana Ranson; Sergey Tarima; Thomas A Hammeke; Christopher Randolph; William B Barr; Kevin Guskiewicz; Christopher M Olsen; E Brooke Lerner; Michael A McCrea Journal: J Neurotrauma Date: 2017-11-17 Impact factor: 5.269