Treating sleep disorders following traumatic brain injury in adults: Time for renewed effort?

Traumatic brain injury (TBI) disrupts normal brain function and can lead to chronic symptoms of sleep disturbance, pain, irritability, and depression. Sleep disorders occur in 30-70% of individuals who have experienced TBI. Disturbed sleep impairs the recovery process and may exacerbate other issues that arise because of brain injury (e.g., headaches, depression). Noticeable benefits have been reported when sleep problems due to TBI are addressed and treated; for instance, treating post-TBI insomnia reduces the expression of inflammatory genes, potentially reducing ongoing neurological damage. In this review, we discuss twenty-four randomised clinical trials (RCT) published to date (August 2021), exploring interventions for sleep disturbances resulting from TBI. Treatment effects were observed for insomnia, circadian rhythm disorders, hypersomnia, and general sleep disturbance. However, the evidence remains limited and significant methodological issues are discussed with a recommendation for further research.