PMID- 17694723
OWN - NLM
STAT- MEDLINE
DCOM- 20071009
LR  - 20181113
IS  - 1550-9389 (Print)
IS  - 1550-9397 (Electronic)
IS  - 1550-9389 (Linking)
VI  - 3
IP  - 4
DP  - 2007 Jun 15
TI  - Sleep disorders in chronic traumatic brain injury.
PG  - 357-62
AB  - STUDY OBJECTIVE: To examine the spectrum of sleep disorders in patients with 
      chronic traumatic brain injury (TBI) and determine if the severity of sleep 
      disorder is related to severity of chronic TBI. METHODS: Patients who underwent 
      evaluation for sleep disorder/s following a TBI were included in this 
      retrospective analysis. Sixty adult patients with TBI (age 20-69 yr; 38 M and 22 
      F), who presented with sleep-related complaints 3 months to 2 years following 
      TBI, were studied. None had sleep complaints prior to the TBI. Orophrayngeal, 
      chin, and TMJ examinations were considered benign. The severity of injury was 
      assessed by the Global Assessment of Functioning (GAF) scale. Polysomnograms 
      (PSGs) were performed on 54 patients (90%), 28 of whom underwent multiple sleep 
      latency tests (MSLTs) because they scored >11 on the Epworth Sleepiness Scale 
      (ESS). The Beck Depression Inventory (BDI) scale was administered if there was 
      sleep maintenance insomnia, and the Hamilton Anxiety Scale (HAS) was administered 
      if there was sleep onset insomnia. RESULTS: The TBI severity was mild in 40%, 
      moderate in 20%, and severe in 40%. The Epworth Sleepiness Scale (ESS) score was 
      elevated (>11) in 52%. Hypersomnia was the presenting complaint in 50%, mostly 
      due to sleep apnea, narcolepsy, and periodic limb movement disorder (PLMD). 
      Insomnia was the presenting complaint in 25%, half with sleep maintenance 
      insomnia and high BDI scores, and the remainder with sleep onset insomnia and 
      high HAS scores. Parasomnia was the presenting complaint in 25%; the most 
      frequent parasomnia was REM behavior disorder (RBD). GAF scores were 
      significantly correlated (p < 0.05) with some of the measures of sleep disruption 
      (stage 1, sleep efficiency, and wake during sleep), but not with others (wake 
      before sleep, stage-shifts, PLMI, PLMA and AHI) on the PSG. Fifty-three percent 
      (15/28) had a mean sleep onset latency <5 minutes, and 32% (9/28), also had two 
      or more sleep onset rapid eye movement periods (SOREMPs) on the MSLT. CONCLUSION: 
      The results of this study demonstrate that a full spectrum of common sleep 
      disorders occurs in patients with chronic TBI. The severity of chronic TBI as 
      measured by GAF scores is correlated with some of the measures of sleep 
      disruption but not others, indicating a complex and multifactorial pathogenesis.
FAU - Verma, Arunima
AU  - Verma A
AD  - B. G. Tricounty Neurology and Sleep Clinic, Warren, MI, USA.
FAU - Anand, Vivek
AU  - Anand V
FAU - Verma, Narayan P
AU  - Verma NP
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Sleep Med
JT  - Journal of clinical sleep medicine : JCSM : official publication of the American 
      Academy of Sleep Medicine
JID - 101231977
SB  - IM
CIN - J Clin Sleep Med. 2007 Jun 15;3(4):347-8. PMID: 17694721
MH  - Adult
MH  - Aged
MH  - Brain Injuries/*epidemiology/*psychology
MH  - Chronic Disease
MH  - Comorbidity
MH  - Depressive Disorder/diagnosis/epidemiology/psychology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Polysomnography/methods/statistics & numerical data
MH  - Psychiatric Status Rating Scales
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Sleep Wake Disorders/diagnosis/*epidemiology/*psychology
MH  - Trauma Severity Indices
PMC - PMC1978305
EDAT- 2007/08/19 09:00
MHDA- 2007/10/10 09:00
PMCR- 2007/12/15
CRDT- 2007/08/19 09:00
PHST- 2007/08/19 09:00 [pubmed]
PHST- 2007/10/10 09:00 [medline]
PHST- 2007/08/19 09:00 [entrez]
PHST- 2007/12/15 00:00 [pmc-release]
PST - ppublish
SO  - J Clin Sleep Med. 2007 Jun 15;3(4):357-62.