Related Experiment Video
Updated: Sep 14, 2025
Author Spotlight: Developing Precise and Clinically Relevant Models for Studying Secondary Degeneration in Traumatic Optic Neuropathy
Published on: November 29, 2024
Course of Fatigue and Sleep After Moderate to Severe Traumatic Brain Injury
Jessica Bruijel1, Sven Stapert, Annemiek Vermeeren
1Author Affiliations: Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands (Drs Bruijel, Stapert, Vermeeren, and Heugten); Limburg Brain Injury Centre, Limburg, The Netherlands (Drs Bruijel and Heugten); Department of Rehabilitation Adelante, Maastricht University Medical Centre+, Maastricht, The Netherlands (Dr Stapert); Department of Neurology, Maastricht University Medical Centre+, Maastricht, The Netherlands (Dr Staals); Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia (Dr Ponsford); and Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia (Dr Ponsford).
Objective:
To examine the development of different dimensions of fatigue and subjective and objective measures of sleep in the first 18 months post moderate to severe traumatic brain injury (TBI), and explore the association with biological (processing speed), psychological (mood), and social (restrictions in participation) factors across time.
Participants:
Forty-two participants with moderate-severe TBI (45 ± 16 years old, 33% female).
Design:
Longitudinal multicenter observational cohort study with 4 measurements (3, 6, 12, and 18 months post-injury).
Main Measures:
Dimensions of fatigue (Fatigue Severity Scale, FSS; Dutch Multifactor Fatigue Scale, DMFS), subjective (Pittsburgh Sleep Quality Index, PSQI) and objective sleep (actigraphy), processing speed (Symbol Digit Modalities Task, SDMT), mood (Hospital Anxiety and Depression Scale, HADS), and restrictions in participation (Utrecht Scale for Evaluation and Rehabilitation-Participation, USER-P).
Results:
Results showed reduced sleep quality (PSQI: poor sleep quality at 3 months 41%; 6 months 43%; 12 months 56%; 18 months 43%) and high levels of fatigue (FSS: severe fatigue at 3 months 41%; 6 months 38%; 12 months 33%; 18 months 34%) with no significant changes over time. Physical fatigue (DMFS: β = -0.11, P = .007) and total sleep time (β = -0.14, P = .015) decreased over time. More mood problems were associated with worse sleep quality (PSQI; β = 0.35, P = .021), shorter total sleep time (β = 0.14, P = .046), and higher levels of fatigue (FSS: β = 0.20, P = .036; DMFS-mental: β = 0.36, P = .028; DMFS-physical: β = 0.36, P = .029). Restrictions in participation were associated with fatigue but not with sleep.
Conclusions:
High and stable levels of fatigue and poor sleep quality in the first 18 months following moderate-severe TBI were found. These symptoms were associated with mood problems. Assessment and treatment of fatigue and sleep problems should be included in clinical practice. In line with other studies, we suggest that mood interventions might aid the treatment for fatigue and sleep quality.
More Related Videos
08:36Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging
Published on: April 11, 2025
09:49Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
Related Concept Videos
01:13Insufficient Sleep and Sleep Deprivation
Sleep deprivation is a more severe form of sleep loss...
01:24Muscle Recovery and Fatigue
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...