Erlan Sanchez1,2, Hélène Blais1, Catherine Duclos3,4, Caroline Arbour5,6, Solenne Van Der Maren1,7, Héjar El-Khatib1,7, Andrée-Ann Baril8,9, Francis Bernard5,10, Julie Carrier1,7, Nadia Gosselin1,7. 1. Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Quebec, Canada. 2. Department of Neuroscience, Université de Montréal, Montreal, Quebec, Canada. 3. Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada. 4. School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada. 5. Centre Intégré de Traumatologie, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Quebec, Canada. 6. Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. 7. Department of Psychology, Université de Montréal, Montreal, Quebec, Canada. 8. Douglas Mental Health University Institute, Montréal, Quebec, Canada. 9. Department of Psychiatry, McGill University, Montréal, Quebec, Canada. 10. Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Abstract
STUDY OBJECTIVES: Traumatic brain injuries (TBIs) cause persistent cerebral damage and cognitive deficits. Because sleep may be a critical factor for brain recovery, we characterized the sleep of patients with TBI from early hospitalization to years post-injury and explored the hypothesis that better sleep during hospitalization predicts more favorable long-term cognitive outcomes. METHODS: We tested patients with moderate-to-severe TBI in the hospitalized (n = 11) and chronic (n = 43) stages using full-night polysomnography, with 82% of the hospitalized group being retested years post-injury. Hospitalized patients with severe orthopedic and/or spinal cord injury (n = 14) and healthy participants (n = 36) were tested as controls for the hospitalized and chronic TBI groups, respectively. Groups had similar age and sex and were compared for sleep characteristics, including slow waves and spindles. For patients with TBI, associations between sleep during hospitalization and long-term memory and executive function were assessed. RESULTS: Hospitalized patients with TBI or orthopedic injuries had lower sleep efficiency, higher wake after sleep onset, and lower spindle density than the chronic TBI and healthy control groups, but only hospitalized patients with brain injury had an increased proportion of slow-wave sleep. During hospitalization for TBI, less fragmented sleep, more slow-wave sleep, and higher spindle density were associated to more favorable cognitive outcomes years post-injury, while injury severity markers were not associated with these outcomes. CONCLUSION: These findings highlight the importance of sleep following TBI, as it could be a strong predictor of neurological recovery, either as a promoter or an early marker of cognitive outcomes.
STUDY OBJECTIVES: Traumatic brain injuries (TBIs) cause persistent cerebral damage and cognitive deficits. Because sleep may be a critical factor for brain recovery, we characterized the sleep of patients with TBI from early hospitalization to years post-injury and explored the hypothesis that better sleep during hospitalization predicts more favorable long-term cognitive outcomes. METHODS: We tested patients with moderate-to-severe TBI in the hospitalized (n = 11) and chronic (n = 43) stages using full-night polysomnography, with 82% of the hospitalized group being retested years post-injury. Hospitalized patients with severe orthopedic and/or spinal cord injury (n = 14) and healthy participants (n = 36) were tested as controls for the hospitalized and chronic TBI groups, respectively. Groups had similar age and sex and were compared for sleep characteristics, including slow waves and spindles. For patients with TBI, associations between sleep during hospitalization and long-term memory and executive function were assessed. RESULTS: Hospitalized patients with TBI or orthopedic injuries had lower sleep efficiency, higher wake after sleep onset, and lower spindle density than the chronic TBI and healthy control groups, but only hospitalized patients with brain injury had an increased proportion of slow-wave sleep. During hospitalization for TBI, less fragmented sleep, more slow-wave sleep, and higher spindle density were associated to more favorable cognitive outcomes years post-injury, while injury severity markers were not associated with these outcomes. CONCLUSION: These findings highlight the importance of sleep following TBI, as it could be a strong predictor of neurological recovery, either as a promoter or an early marker of cognitive outcomes.
Authors: Jerrah K Holth; Sarah K Fritschi; Chanung Wang; Nigel P Pedersen; John R Cirrito; Thomas E Mahan; Mary Beth Finn; Melissa Manis; Joel C Geerling; Patrick M Fuller; Brendan P Lucey; David M Holtzman Journal: Science Date: 2019-01-24 Impact factor: 47.728
Authors: Peter Meerlo; Ralph E Mistlberger; Barry L Jacobs; H Craig Heller; Dennis McGinty Journal: Sleep Med Rev Date: 2008-10-09 Impact factor: 11.609