Citation

Wickwire E, Schnyer DM, Germain A, Smith MT, Williams S, Lettieri C, McKeon A, Scharf S, Stocker R, Albrecht JS, Badjatia N, Markowitz A, Manley G. J. Neurotrauma 2018; 35(22): 2615-2631.

Affiliation

University of California, San Francisco, Neurosurgery, San Francisco, California, United States ; manleyg@ucsf.edu.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5243

PMID

29877132

Abstract

A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). Although many questions remain unanswered, the preponderance of evidence suggests that sleep and circadian disorders can result from mTBI. Among those with mTBI, sleep disturbances and clinical sleep and circadian disorders contribute to the morbidity and long-term sequelae across domains of functional outcomes and quality of life. Specifically, along with deterioration of neurocognitive performance, insufficient and disturbed sleep can precede, exacerbate, or perpetuate many of the other common sequelae of mTBI, including depression, post-traumatic stress disorder, and chronic pain. Further, sleep and mTBI share neurophysiologic and neuroanatomic mechanisms that likely bear directly on success of rehabilitation following mTBI. For these reasons, focus on disturbed sleep as a modifiable treatment target has high likelihood of improving outcomes in mTBI. Here, we review relevant literature and present a research agenda to 1) advance understanding of the reciprocal relationships between sleep and circadian factors and mTBI sequelae and 2) advance rapidly the development of sleep-related treatments in this population.

Language: en

Keywords

EEG; REHABILITATION; TRAUMATIC BRAIN INJURY