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Traumatic brain injury (TBI) is a major public health concern in part because its incidence is estimated at more than 600/100 000 individuals, but also because it can result in long-term cognitive, physical, neurobehavioural and psychological impairments. Sleep–wake disturbances, particularly fatigue, hypersomnia and insomnia, are among the most severe, the most persistent and the most disabling symptoms after TBI. They affect at least 50% of this population and are present across the range of TBI severity. However, whether post-traumatic sleep–wake disturbances improve or persist over time remains unclear. The paper by Kempf et al1 (see page 1402) presents a prospective study on 51 …