SEATTLE—Insomnia is significantly more prevalent among patients with mild traumatic brain injury (TBI) than in the general population, according to research presented at the 23rd Annual Meeting of the Associated Professional Sleep Societies. Other nighttime sleep problems and excessive daytime sleepiness are also strongly associated with mild TBI, reported Michael B. Russo, MD, and colleagues.
Because TBI may disrupt various components of the sleep/wake regulatory network, the investigators had hypothesized that patients with TBI would have a high incidence of insomnia and other sleep-related problems. Dr. Russo’s group reviewed medical records of 35 patients (30 males; mean age, 30) with mild TBI; 20 subjects were military service members. All patients had attended a military neurology clinic for sleep-related complaints, and no patients had had insomnia before incurring a head injury.
The researchers found that 31 patients (89%) had insomnia, compared with an estimated rate of 10% in the general adult population. In addition, 27 patients had sleep-onset insomnia, 30 had difficulty staying asleep, 15 awakened throughout the night, and 11 awakened in the early morning. Furthermore, 23 patients had more than one type of insomnia, according to Dr. Russo, Colonel, Medical Corps, US Army, Tripler Army Medical Center in Honolulu.
The investigators also found that 34 patients had a sleep/wake-related problem and that 31 had excessive daytime sleepiness. Sleep/wake-related problems were defined as having daytime dysfunction associated with not being able to fall asleep, feeling restless at night, having nightmares, awakening at night, awakening in the early morning, and having excessive daytime sleepiness. Excessive daytime sleepiness was defined as having direct complaints, naps, and decreased social and work performance due to sleepiness.
“We suggest that screening for insomnia and sleep/wake-related problems be considered in all patients suspected of having mild TBI,” said Dr. Russo.
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—Colby Stong