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Association of Sleep and Co-Occurring Psychological Conditions at 1 Year After Traumatic Brain Injury
Archives of Physical Medicine and Rehabilitation, 08/10/2012
Clinical Article
Fogelberg DJ et al. – Sleep difficulties are a frequent problem at 1 year after traumatic brain injury (TBI), and often co–occur with depression, anxiety, and pain. Assessment and treatment of sleep difficulties should be included in clinical practice.
Methods- Individuals with TBI (N=174) were recruited from consecutive admissions to an inpatient rehabilitation unit and enrolled into the TBI Model Systems study.
- Participant mean age was 38, and mean Glasgow Coma Scale score on admission was 9.3. Seventy-eight percent of the sample were men.
- Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI).
- Depression, anxiety, and pain were measured with the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 Scale, and an analog pain rating scale, respectively.
- Participants with TBI reported significantly greater sleep difficulties than the healthy comparison group.
- Forty-four percent of participants with TBI reported significant sleep problems (PSQI>5).
- Participants with 1 or more co-occurring conditions (depression, pain, or anxiety) had significantly worse sleep than those without such a condition.
- The highest level of sleep problems was reported by participants with multiple co-occurring conditions.
- Sleep problems were also associated with poor functional status.
