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Characterization of Patient-Reported Sleep and Mood Symptoms in Chronic Mild Traumatic Brain Injury
Kennedy Johnson1, Alyssa M Civantos1, Nina Patel1
1Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA.
Objective:
Traumatic brain injury (TBI) affects approximately two million individuals in the United States annually, with most cases classified as mild (mTBI). Reported prevalence of insomnia, excessive daytime sleepiness, or obstructive sleep apnea (OSA) ranges from 30% to 70% in patients with mTBI. Sleep disorders may interfere with recovery and contribute to disability. This study characterizes self-reported impairments in sleep and mood among patients with mTBI.
Methods:
This cross-sectional retrospective study at a Level 1 trauma center included adults with mTBI (Glasgow Coma Scale ≥ 13) diagnosed ≥ 6 months prior. Patients with substance dependence were excluded. Patients completed the Neurobehavioral Symptom Inventory (NSI), Epworth Sleepiness Scale (ESS), STOP-BAG, Insomnia Severity Index (ISI), Functional Outcome of Sleep Questionnaire-10 (FOSQ-10), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). Regression analyses controlling for age, body mass index, and time from injury were performed.
Results:
We recruited 46 subjects, of which 74% (34) were male and 61% (28) were White. Mean (±SD) age was 53 (±17.07) years. Mean (±SD) scores were ESS 8.32 (±5.86), STOP-BAG 2.5 (±1.57), ISI 10.05 (±8.87), FOSQ-10 13.02 (±6.90), PHQ-9 7.02 (±6.72), and GAD-7 6.71 (±6.81). Univariate analyses showed significant associations between NSI and each of ESS, ISI, FOSQ-10, PHQ-9, and GAD-7 (p < 0.01).
Conclusion:
Patients with mTBI commonly report chronic impairments in sleep and psychological well-being. These findings emphasize the need for comprehensive management and identify the importance of screening for sleep disorders in this population.
