How do sleep disturbances manifest in traumatic brain injury (TBI), and how is insomnia treated?

Updated: Mar 02, 2020
  • Author: Percival H Pangilinan, Jr, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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In one study, patients with TBI reported higher rates of sleep changes than did sex-matched control subjects (80% vs 23%). [31] The TBI group reported more nighttime awakenings and longer sleep-onset latency than did the other group. Increased levels of anxiety and depression were risk factors that may have partly accounted for increased complaints of excessive daytime sleepiness.

A cross-sectional case-comparison study by Wei et al found a high prevalence of sleep disturbances, including obstructive sleep apnea (OSA), insomnia, and daytime sleepiness, in adults aged 65 years or above who had suffered traumatic brain injury (TBI). The investigators reported a significant correlation in older adults between male gender and OSA, while the presence of higher degrees of depression and pain was correlated with insomnia, and the occurrence of insomnia was associated with daytime sleepiness. The data also indicated that the correlation of OSA and insomnia with low quality of life is significant in the older population. [64]

Light therapy may mitigate TBI-related sleep disturbances. In a small study that included 18 adults with a history of at least 1 mild TBI and sleep disturbance that developed after, or was exacerbated by, the most recent injury, morning bright-light therapy led to improvements in sleep, cognition, emotion, and brain function. [65, 66]

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