According to the CDC, in 2014 there were approximately 2.87 million cases of traumatic brain injuries, also known as concussions, resulting in emergency department visits, hospitalizations, and deaths. Beyond headaches and nausea, this common condition, which is usually caused by falls, violence, or sports injuries, has been associated with an increased need for sleep or difficulty sleeping.
Moreover, researchers of a study published in the Journal of Neurotrauma note that sleep-wake disturbances (SWDs) and fatigue are common after mild concussions, with insomnia and hypersomnolence disorder reported as most common.
"Most people fully recover from their problems after a short time, but some individuals suffer long-term problems that affect their quality of life, work and school," said lead study author Simen Berg Saksvik, PhD candidate at the Norwegian University of Science and Technology's Department of Psychology.
Saksvik and fellow researchers sought to better understand the prevalence and stability of SWDs and fatigue among patients with mild concussion. They conducted a prospective, longitudinal study that compared 378 patients with mild concussion with 82 matched trauma controls with orthopedic injuries and 83 matched community controls. Participants were assessed for increased sleep need, poor sleep quality, excessive daytime sleepiness, and fatigue at 2 weeks, 3 months, and 12 months after injury.
Clinically relevant group differences were longitudinally evaluated via mixed logistic regression models.
In the study findings, prevalence of increased sleep need, poor sleep quality, and fatigue were all significantly higher in patients with mild concussion than in both trauma controls and community controls at all time points. Additionally, more patients with mild concussion reported problems with excessive daytime sleepiness compared with trauma controls, but not community controls, at all time points.
Among patients with complicated mild concussion, characterized by intracranial findings on CT or MRI, more fatigue problems were reported compared with those with uncomplicated mild concussion, at all 3 time points.
Furthermore, in patients with mild concussion who experienced SWDs and fatigue 2 weeks after injury, nearly half still had problems at 3 months and approximately one-third at 12 months. There was limited overlap observed between the different symptom measures, noted researchers, in which a large number of patients reported 1 specific problem with SWD or fatigue rather than several problems.
“Sleep problems are often associated with issues like poor memory, concentration difficulties, depression and anxiety. Treating sleep problems as early possible as after a concussion may help slow down or prevent the development of such problems,” said Saksvik. “Now we‘re planning to investigate biological explanatory models for sleep disturbances by using brain imaging and blood tests collected from these individuals.”
Saksvik SB, Karaliute M, Kallestad H, et al. The prevalence and stability of sleep-wake disturbance and fatigue throughout the first year after mild traumatic brain injury. J Neurotrauma. Published online July 8, 2020. doi:10.1089/neu.2019.6898