Poor Sleep Quality and Changes in Objectively Recorded Sleep After Traumatic Brain Injury: A Preliminary Study
Presented in part to the Fatigue and Sleep Symposium of the International Neuropsychological Society, July 2006, Zurich, Switzerland.
Abstract
Parcell DL, Ponsford JL, Redman JR, Rajaratnam SM. Poor sleep quality and changes in objectively recorded sleep after traumatic brain injury: a preliminary study.
Objectives
To evaluate changes in sleep quality and objectively assessed sleep parameters after traumatic brain injury (TBI) and to investigate the relationship between such changes and mood state and injury characteristics.
Design
Survey and laboratory-based nocturnal polysomnography.
Setting
Sleep laboratory.
Participants
Ten community-based subjects with moderate to very severe TBI and 10 age- and sex-matched controls from the general community.
Interventions
Not applicable.
Main Outcome Measures
Pittsburgh Sleep Quality Index for self-report sleep quality, nocturnal polysomnography for objective sleep recording, and Hospital Anxiety and Depression Scales.
Results
Compared with controls, TBI patients reported significantly poorer sleep quality and higher levels of anxiety and depression. Objective sleep recording showed that TBI patients showed an increase in deep (slow wave) sleep, a reduction in rapid eye movement sleep, and more frequent nighttime awakenings. No significant relationship was observed between these changes in sleep and injury severity or time since injury. Anxiety and depression covaried with the observed changes in sleep.
Conclusions
The findings contribute to the growing body of evidence that sleep is involved in the physiologic processes underlying neural recovery. The association between anxiety and depression and the observed changes in sleep in TBI patients warrants further examination to determine whether a causative relationship exists.
aSchool of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, Australia
bMonash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.
Reprint requests to Shantha M. Rajaratnam, PhD, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Bldg 17, Victoria 3800, Australia
Supported in part by the National Health and Medical Research Council (project no. 334002).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT