Sleep–wake disturbances 3 years after traumatic brain injury
- 1Department of Neurology, University Hospital Zurich, Zurich, Switzerland
- 2Department of Neurology, Ospedale Civico, Lugano, Switzerland
- Correspondence to Christian R Baumann, Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland;
- Received 30 November 2009
- Revised 14 May 2010
- Accepted 24 June 2010
- Published Online First 30 September 2010
Background 6 months after traumatic brain injury (TBI), almost three out of four patients suffer from sleep–wake disturbances (SWD) such as post-traumatic hypersomnia (increased sleep need of ≥2 h compared with before injury), excessive daytime sleepiness (EDS), fatigue and insomnia. The long-term course of post-traumatic SWD, however, is unknown.
Objectives To assess the prevalence and characteristics of post-traumatic SWD 3 years after trauma.
Design Prospective longitudinal clinical study in 51 consecutive TBI patients (43 males, eight females, mean age 40±16 years).
Main outcome measures EDS (as assessed by the Epworth sleepiness scale), fatigue (fatigue severity scale), post-traumatic hypersomnia (sleep length per 24 h), insomnia, depression and anxiety.
Results Post-traumatic SWD were found in 34 patients (67%): post-traumatic hypersomnia in 14 (27%), EDS in six (12%), fatigue in 18 patients (35%) and insomnia in five patients (10%). SWD were not associated with severity or localisation of, or time interval since, TBI. Insomnia was linked to depressive symptoms.
Conclusions This prospective study shows that 3 years after TBI, two out of three patients suffer from residual SWD, particularly fatigue and post-traumatic hypersomnia. In 45% of TBI patients, SWD appear directly related to the trauma itself.
Linked articles 222471.
Funding This study has been supported by the Schweizerischer Versicherungsverband SVV, Zurich, Switzerland.
Competing interests None.
Patient consent Obtained.
Ethics approval Ethics approval was provided by the Ethical Committee, University of Zurich.
Provenance and peer review Not commissioned; externally peer reviewed.