Citation

Chan LG, Feinstein A. J. Head Trauma Rehabil. 2015; 30(6): E67-75.

Affiliation

Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Dr Chan), and, Department of Psychological Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore (Dr Chan); and Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Dr Feinstein).

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000119

PMID

25931180

Abstract

OBJECTIVE: To investigate the effect of sleep disturbances on functional and social outcomes after mild traumatic brain injury. SETTING: Outpatient traumatic brain injury clinic in a tertiary trauma center. PARTICIPANTS: A total of 374 mild traumatic brain injury patients were assessed within 3 months of injury and followed up every 3 months for 1 year.

DESIGN: Analysis of a historical cohort in a naturalistic clinical setting. MAIN MEASURES: At each visit, symptoms of concussion and psychological distress and indices of functional and social outcomes were measured with the Rivermead Postconcussion Questionnaire, 28-item General Health Questionnaire, and Rivermead Head Injury Follow-up Questionnaire, respectively. Changes in outcome scores over time were explored using repeated measures analysis of variance and compared between subjects with persistent (SD) and recovered (SR) sleep disturbances. Predictors of functional/social outcome were determined using linear regression.

RESULTS: The percentages of subjects reporting sleep disturbances at each time point were 71.9%, 57.2%, 55.1%, and 53.7%, respectively. For functional and social outcomes, significant effects of time (F3,315 = 9.54; P <.001), group (SD vs SR) F1,317 = 5.32; P =.022, and time X group interaction F3,315 = 4.14; P =.007 were found. Persistent sleep disturbance (P = 0.011) and higher symptom burden at 6 months postinjury (P <.0001) were independent predictors of poorer outcome.

CONCLUSION: Sleep disturbance, independent of psychological distress, is an important prognostic factor of functional and social outcomes after mild traumatic brain injury.

Language: en