Poor sleep quality is associated with greater negative consequences for cognitive control function and psychological health after mild traumatic brain injury than after orthopedic injury.

2021 ◽  
Author(s):  
Simen Berg Saksvik ◽  
Hanne Smevik ◽  
Jonas Stenberg ◽  
Turid Follestad ◽  
Anne Vik ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Mild Traumatic Brain Injury ◽  
Psychological Health ◽  
Control Function ◽  
Poor Sleep ◽  
Negative Consequences ◽  
Poor Sleep Quality ◽  
Orthopedic Injury

scholarly journals Screening for Poor Self-Reported Sleep Quality at 12 Weeks in Post-Mild Traumatic Brain Injury Patients Using the HF–Age–Gender (HAG) Index

2021 ◽  
Vol 11 (11) ◽  
pp. 1369
Author(s):  
Hon-Ping Ma ◽  
Ju-Chi Ou ◽  
Kai-Yun Chen ◽  
Kuo-Hsing Liao ◽  
Shuo-Jhen Kang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Mild Traumatic Brain Injury ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Non Invasive ◽  
Patient Will ◽  
Improve Sleep Quality

To identify a screening tool for poor self-reported sleep quality at 12 weeks according to non-invasive measurements and patients’ characteristics in the first week after mild traumatic brain injury (mTBI), data from 473 mTBI participants were collected and follow-ups were performed at 12 weeks. Patients with previous poor self-reported sleep quality prior to the injury were excluded. Patients were then divided into two groups at 12 weeks according to the Pittsburgh Sleep Quality Index based on whether or not they experienced poor sleep quality. The analysis was performed on personal profiles and heart rate variability (HRV) for 1 week. After analyzing the non-invasive measurements and characteristics of mTBI patients who did not complain of poor sleep quality, several factors were found to be relevant to the delayed onset of poor sleep quality, including age, gender, and HRV measurements. The HRV–age–gender (HAG) index was proposed and found to have 100% sensitivity (cut-off, 7; specificity, 0.537) to predicting whether the patient will experience poor sleep quality after mTBI at the 12-week follow-up. The HAG index helps us to identify patients with mTBI who have no sleep quality complaints but are prone to developing poor self-reported sleep quality. Additional interventions to improve sleep quality would be important for these particular patients in the future.

Poor sleep quality is associated with greater negative consequences for neurocognitive and psychological health after mild traumatic brain injury than after orthopedic injury

2020 ◽  
Author(s):  
Simen Saksvik ◽  
Hanne Smevik ◽  
Jonas Stenberg ◽  
Truid Follestad ◽  
Anne Vik ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Psychological Distress ◽  
Sleep Quality ◽  
Psychological Health ◽  
Negative Impact ◽  
Response Speed ◽  
Poor Sleep ◽  
Response Accuracy ◽  
Poor Sleep Quality ◽  
Orthopedic Injury

Objective: To test the hypothesis that poor sleep quality has a stronger negative effect on neurocognitive and psychological health after mild traumatic brain injury (mTBI) than after orthopedic injury. Method: Patients with mTBI (n=197) and trauma controls with orthopedic injuries (n=82) were included in this prospective longitudinal study. The participants (age 16-60) completed three computerized neurocognitive tests assessing response speed and accuracy at 2 weeks and 3 months after injury, as well as questionnaires and interviews assessing sleep quality and psychological distress at 2 weeks, 3 months and 12 months after injury. Separate linear mixed models (LMMs) for each of the outcome measures (response speed, response accuracy, psychological distress) were performed. Results: We observed a significant interaction effect between poor sleep quality and group (mTBI vs trauma controls) in the response speed (p=0.021) and psychological distress (p=0.001) models, driven by a greater negative impact of poor sleep quality on response speed and psychological distress in the mTBI group. We found no such interaction effect for response accuracy (p=0.825), and poor sleep quality was associated with worse accuracy to a similar extent for both groups. Conclusions: Our findings show that poor sleep quality has a more negative impact on neurocognitive and psychological outcome in patients with mTBI, compared to trauma controls. This indicates an increased vulnerability to poor sleep quality in patients who has suffered a mTBI.

scholarly journals Comprehensive insomnia assessment following mild traumatic brain injury

2021 ◽  
Author(s):  
Dora M. Zalai
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Primary Insomnia ◽  
Chronic Insomnia ◽  
Poor Sleep ◽  
Wake Time ◽  
Insomnia Symptoms

Background and Rationale: Insomnia symptoms following mild traumatic brain injury (mTBI) predict poor TBI outcomes. Insomnia symptoms may be caused by sleep disorders that can be effectively treated, which in turn, may improve mTBI outcomes. Previous studies have focused on insomnia symptom assessment in mTBI or evaluated samples with all TBI severities. To effectively manage insomnia following mTBI, it is important to understand which sleep disorders contribute to insomnia symptoms in this clinical group. Furthermore, it is important to extend research on primary insomnia to determine which variables are related to the perception of poor sleep among individuals who report new onset/worsening insomnia symptoms following mTBI. Objectives: (1) determine the prevalence of sleep disorders that contribute to chronic insomnia symptoms in patients with mTBI and (2) determine which objectively measured electroencephalographic and subjective variables are associated with subjective wake time and the perception of poor sleep among patients with chronic insomnia symptoms following mTBI. Methods: Individuals with chronic insomnia symptoms following mTBI (N = 50; age 17-65; 64% females; 3 - 24 months post mTBI) participated in a multi-method sleep and circadian assessment. Sleep disorders were diagnosed according to ICSD-3 criteria. Results: Insomnia disorder was the most common diagnosis (62%), followed by obstructive sleep apnea (OSA) -44%; circadian rhythm sleep-wake disorders (CRSWD) - 26% and periodic limb movement disorder (PLMD) - 8%. The overestimation of wake time was similar to what has been described in primary insomnia. In contrast to the REM instability hypothesis of primary insomnia, REM sleep duration was not related to subjective wake time. Both low sleep quality and feeling unrested in the morning had the strongest relationship to subjective wake time. Feeling unrested was also associated with anxiety. Conclusions: OSA and CRSWD frequently occur among patients whose main presenting sleep symptom is chronic insomnia following a mTBI. Accordingly, objective sleep and circadian assessment should be part of chronic insomnia evaluation following a mTBI. The results imply that interventions reducing subjective wake time and anxiety could improve subjective sleep quality; however, these interventions should be mplemented in conjunction with the treatment for OSA, CRSWD and PLMD.

scholarly journals Comprehensive insomnia assessment following mild traumatic brain injury

2021 ◽  
Author(s):  
Dora M. Zalai
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Primary Insomnia ◽  
Chronic Insomnia ◽  
Poor Sleep ◽  
Wake Time ◽  
Insomnia Symptoms

Background and Rationale: Insomnia symptoms following mild traumatic brain injury (mTBI) predict poor TBI outcomes. Insomnia symptoms may be caused by sleep disorders that can be effectively treated, which in turn, may improve mTBI outcomes. Previous studies have focused on insomnia symptom assessment in mTBI or evaluated samples with all TBI severities. To effectively manage insomnia following mTBI, it is important to understand which sleep disorders contribute to insomnia symptoms in this clinical group. Furthermore, it is important to extend research on primary insomnia to determine which variables are related to the perception of poor sleep among individuals who report new onset/worsening insomnia symptoms following mTBI. Objectives: (1) determine the prevalence of sleep disorders that contribute to chronic insomnia symptoms in patients with mTBI and (2) determine which objectively measured electroencephalographic and subjective variables are associated with subjective wake time and the perception of poor sleep among patients with chronic insomnia symptoms following mTBI. Methods: Individuals with chronic insomnia symptoms following mTBI (N = 50; age 17-65; 64% females; 3 - 24 months post mTBI) participated in a multi-method sleep and circadian assessment. Sleep disorders were diagnosed according to ICSD-3 criteria. Results: Insomnia disorder was the most common diagnosis (62%), followed by obstructive sleep apnea (OSA) -44%; circadian rhythm sleep-wake disorders (CRSWD) - 26% and periodic limb movement disorder (PLMD) - 8%. The overestimation of wake time was similar to what has been described in primary insomnia. In contrast to the REM instability hypothesis of primary insomnia, REM sleep duration was not related to subjective wake time. Both low sleep quality and feeling unrested in the morning had the strongest relationship to subjective wake time. Feeling unrested was also associated with anxiety. Conclusions: OSA and CRSWD frequently occur among patients whose main presenting sleep symptom is chronic insomnia following a mTBI. Accordingly, objective sleep and circadian assessment should be part of chronic insomnia evaluation following a mTBI. The results imply that interventions reducing subjective wake time and anxiety could improve subjective sleep quality; however, these interventions should be mplemented in conjunction with the treatment for OSA, CRSWD and PLMD.

Poor Sleep Quality and Changes in Objectively Recorded Sleep After Traumatic Brain Injury: A Preliminary Study

2008 ◽  
Vol 89 (5) ◽  
pp. 843-850 ◽  
Author(s):  
Diane L. Parcell ◽  
Jennie L. Ponsford ◽  
Jennifer R. Redman ◽  
Shantha M. Rajaratnam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Preliminary Study

scholarly journals Poor sleep correlates with biomarkers of neurodegeneration in mild traumatic brain injury patients: a CENC Study

SLEEP ◽  
2020 ◽  
Author(s):  
J Kent Werner ◽  
Pashtun Shahim ◽  
Josephine U Pucci ◽  
Lai Chen ◽  
Sorana Raiciulescu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Executive Function ◽  
Brain Injury ◽  
Cognitive Function ◽  
Sleep Quality ◽  
Mild Traumatic Brain Injury ◽  
Poor Sleep ◽  
Neurofilament Light ◽  
Therapeutic Implications ◽  
Obstructive Sleep

Abstract Study Objectives Sleep disorders affect over half of mild traumatic brain injury (mTBI) patients. Despite evidence linking sleep and neurodegeneration, longitudinal TBI-related dementia studies have not considered sleep. We hypothesized that poor sleepers with mTBI would have elevated markers of neurodegeneration and lower cognitive function compared to mTBI good sleepers and controls. Our objective was to compare biomarkers of neurodegeneration and cognitive function with sleep quality in warfighters with chronic mTBI. Methods In an observational warfighters cohort (n=138 mTBI, 44 controls), the Pittsburgh Sleep Quality Index (PSQI) was compared with plasma biomarkers of neurodegeneration and cognitive scores collected an average of 8 years after injury. Results In the mTBI cohort, poor sleepers (PSQI≥10, n = 86) had elevated plasma neurofilament light (NfL, x̅ = 11.86 vs. 7.91 pg/mL, p=0.0007, d=0.63) and lower executive function scores by the categorical fluency (x̅ = 18.0 vs 21.0, p=0.0005, d= -0.65) and stop-go tests (x̅ = 30.1 vs 31.1, p=0.024, d = -0.37). These findings were not observed in controls (n = 44). PSQI predicted NfL (Beta=0.22, p=0.00002) and tau (Beta=0.14, p=0.007), but not amyloid β42. Poor sleepers showed higher obstructive sleep apnea (OSA) risk by STOP-BANG scores (x̅ = 3.8 vs 2.7, p=0.0005), raising the possibility that the PSQI might be partly secondary to OSA. Conclusions Poor sleep is linked to neurodegeneration and select measures of executive function in mTBI patients. This supports implementation of validated sleep measures in longitudinal studies investigating pathobiological mechanisms of TBI related neurodegeneration, which could have therapeutic implications.

020 Sleep Quality Affects the Plasma Exosomal MicroRNA Expression Profile in Military Personnel with Traumatic Brain Injury

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A9-A10
Author(s):  
Sara Mithani ◽  
Jacqueline Leete ◽  
Josephine Pucci ◽  
Viivan Guedes ◽  
Kimbra Kenney ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Military Personnel ◽  
Sleep Disturbances ◽  
Poor Sleep ◽  
Ptsd Symptoms ◽  
Poor Sleep Quality ◽  
Disturbed Sleep ◽  
Exosomal Microrna

Abstract Introduction Disordered sleep is a critical issue facing the US military due to its negative impact on maintaining force readiness, health, and well-being. Traumatic brain injury (TBI) is highly prevalent among military personnel and commonly co-occurs with disturbed sleep: up to 89% of military service members with TBI report poor sleep quality. Disturbed sleep is a hallmark of post-traumatic stress disorder (PTSD), which often coexists with TBI, with upward of 90% of patients with PTSD reporting some form of sleep disturbance. The pathophysiological mechanisms underlying sleep disturbances in TBI patients remain elusive. Exosomal microRNA (exomiRs), which are implicated in intracellular communication, may provide novel insight into molecular networks related to sleep disturbances in TBI patients. Methods ExomiR was extracted from plasma samples of 108 post-9/11 military personnel, and veterans with a history of mild TBI enrolled in a multicenter prospective longitudinal study. ExomiR profiling analysis was conducted using nCounter Human v3 miRNA Expression Panel with 798 microRNA probes. Sleep quality was assessed using the global score on the Pittsburgh Sleep Quality Index (PSQI), and symptoms of PTSD were measured with the PTSD Checklist for DSM-5 (PCL-5). Generalized linear models and Spearman’s correlations were constructed to analyze the relationship between levels of exomiR and global PSQI score. Results We found 17 exomiR that were significantly (P < 0.05) associated with sleep quality and 11 exomiR significantly associated with PTSD symptoms. Two exomiR, has-miR-1268a and has-miR-139-5p, were significantly associated with both sleep quality and PTSD symptoms. The top three significant exomiR associated with sleep quality were hsa-miR-1250-5p (r = 0.2295, p = 0.0171), hsa-miR-3615(r = 0.2207, p = 0.0229), and hsa-miR-122-5p(r = 0.2069, p = 0.0132). Conclusion Overall, these findings suggest that analysis of exosomal miRNA expression may provide novel insights into the underlying pathobiology of sleep quality in military personnel with mild TBI, independent of PTSD symptoms. Further research is needed to understand the biological underpinnings of poor sleep quality in individuals with TBI and to determine causal links. Support (if any) Intramural Research Program at the NINR, Department of Defense, Chronic Effects of Neurotrauma Consortium (CENC) Award W81XWH-13-2-0095 and Department of Veterans Affairs CENC Award I01 CX001135.

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