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Research Article Open Access
The primary acceleration-deceleration mechanism of traumatic brain injury (TBI) leaves the brain structures that regulate sleep and wakefulness vulnerable to pathological changes, and there are external secondary factors experienced post-injury that can contribute to the development of difficulties initiating or maintaining sleep, early morning awakening, and/or dissatisfaction with sleep. Patients with TBI are at risk for developing chronic sleep-wake disturbances, and complaints of insomnia and hypersomnia are commonly reported. The objective of this study was to examine sleep architecture and explore the presence and types of sleep disorders in adults with chronic TBI. Method: Participants (N=13, mean time post injury 4.5 years) underwent polysomnography and the Maintenance of Wakefulness Test. Polysomnographic findings were compared to age and sex normative data. Sleep disorders were diagnosed according to the criteria of the International Classification of Sleep Disorders, 2nd edition. Results: Compared to normative data, 92% had abnormal sleep architecture with increased N1 (p=.002), reductions in REM sleep (p=0.017) and total sleep time, and poor sleep efficiency. All were diagnosed with a treatable sleep disorder according to the ICSD-2. Conclusion: These exploratory findings add to a growing body of evidence that TBI is associated with a high prevalence of sleep disorders which underlie alterations in sleep architecture including increased arousability, greater amounts of transitional sleep stages, and altered REM latency and duration.These results highlight the importance of regular screening and assessment of sleep-wake disorders early in the rehabilitation stage for this population in order to prevent the development of chronic sleep disorders.
Sleep, Sleep disorders, Traumatic brain injury, Polysomnography, Sleep architecture, Sleep Therapy, Sleep Disorders, Sleep Disorders Treatment