Tatyana Mollayeva1, Angela Colantonio2, J David Cassidy3, Lee Vernich4, Rahim Moineddin4, Colin M Shapiro5. 1. Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Collaborative Program in Neuroscience, University of Toronto, Canada; Toronto Rehab-University Health Network, Ontario, Canada. Electronic address: tatyana.mollayeva@utoronto.ca. 2. Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, Canada. 3. Division of Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Canada; Division of Epidemiology, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Canada. 4. Division of Epidemiology, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Canada. 5. Faculty of Arts and Science, University of Toronto, Canada; Toronto Western Hospital, University Health Network, Ontario, Canada; Youthdale Child & Adolescent Sleep Clinic, Ontario, Canada.
Abstract
OBJECTIVE AND BACKGROUND: Sleep stage disruption in persons with mild traumatic brain injury (mTBI) has received little research attention. We examined deviations in sleep stage distribution in persons with mTBI relative to population age- and sex-specific normative data and the relationships between such deviations and brain injury-related, medical/psychiatric, and extrinsic factors. PATIENTS AND METHODS: We conducted a cross-sectional polysomnographic investigation in 40 participants diagnosed with mTBI (mean age 47.54 ± 11.30 years; 56% males). MEASUREMENTS: At the time of investigation, participants underwent comprehensive clinical and neuroimaging examinations and one full-night polysomnographic study. We used the 2012 American Academy of Sleep Medicine recommendations for recording, scoring, and summarizing sleep stages. We compared participants' sleep stage data with normative data stratified by age and sex to yield z-scores for deviations from available population norms and then employed stepwise multiple regression analyses to determine the factors associated with the identified significant deviations. RESULTS: In patients with mTBI, the mean duration of nocturnal wakefulness was higher and consolidated sleep stage N2 and REM were lower than normal (p < 0.0001, p = 0.018, and p = 0.010, respectively). In multivariate regression analysis, several covariates accounted for the variance in the relative changes in sleep stage duration. No sex differences were observed in the mean proportion of non-REM or REM sleep. CONCLUSIONS: We observed longer relative nocturnal wakefulness and shorter relative N2 and REM sleep in patients with mTBI, and these outcomes were associated with potentially modifiable variables. Addressing disruptions in sleep architecture in patients with mTBI could improve their health status.
OBJECTIVE AND BACKGROUND: Sleep stage disruption in persons with mild traumatic brain injury (mTBI) has received little research attention. We examined deviations in sleep stage distribution in persons with mTBI relative to population age- and sex-specific normative data and the relationships between such deviations and brain injury-related, medical/psychiatric, and extrinsic factors. PATIENTS AND METHODS: We conducted a cross-sectional polysomnographic investigation in 40 participants diagnosed with mTBI (mean age 47.54 ± 11.30 years; 56% males). MEASUREMENTS: At the time of investigation, participants underwent comprehensive clinical and neuroimaging examinations and one full-night polysomnographic study. We used the 2012 American Academy of Sleep Medicine recommendations for recording, scoring, and summarizing sleep stages. We compared participants' sleep stage data with normative data stratified by age and sex to yield z-scores for deviations from available population norms and then employed stepwise multiple regression analyses to determine the factors associated with the identified significant deviations. RESULTS: In patients with mTBI, the mean duration of nocturnal wakefulness was higher and consolidated sleep stage N2 and REM were lower than normal (p < 0.0001, p = 0.018, and p = 0.010, respectively). In multivariate regression analysis, several covariates accounted for the variance in the relative changes in sleep stage duration. No sex differences were observed in the mean proportion of non-REM or REM sleep. CONCLUSIONS: We observed longer relative nocturnal wakefulness and shorter relative N2 and REM sleep in patients with mTBI, and these outcomes were associated with potentially modifiable variables. Addressing disruptions in sleep architecture in patients with mTBI could improve their health status.
Authors: Emerson M Wickwire; David M Schnyer; Anne Germain; Scott G Williams; Christopher J Lettieri; Ashlee B McKeon; Steven M Scharf; Ryan Stocker; Jennifer Albrecht; Neeraj Badjatia; Amy J Markowitz; Geoffrey T Manley Journal: J Neurotrauma Date: 2018-08-24 Impact factor: 5.269
Authors: Arthur Maerlender; Caitlin Masterson; Jessica L Calvi; Todd Caze; Ross Mathiasen; Dennis Molfese Journal: Sports Med Health Sci Date: 2020-07-09