Long after brain trauma, sleep problems persist
At least 18 months after sustaining a traumatic brain injury, first-time concussion victims continue to need more sleep and to suffer more daytime sleepiness than do healthy people, says new research. But even as they run higher risks of such injuries as vehicle crashes, sufferers routinely underestimate both their sleepiness and their increased sleep need, the study finds.
Experts in neurotrauma have long known that the concussed brain needs extra rest to heal, even as patients’ sleep-wake cycles are disrupted by the injury. In the weeks following a serious blow to the head, patients are urged to get extra sleep, and to limit their physical and cognitive exertion.
On average, 1½ years after their brain injury, subjects slept 8.1 hours per night vs. 7.1 hours for healthy controls. Even with that extra hour, they were more tired during their wakeful hours, as measured by how quickly they fell asleep.
The new study, conducted in Switzerland, was published online Wednesday in the journal Neurology. It appears to be the longest prospective study about sleep quality and TBI published to date. Researchers conducted nightlong sleep studies, tracked subjects’ sleep with devices worn on the wrist, performed structured interviews about sleep and daytime wakefulness, and measured how quickly subjects fell asleep when their heads hit the pillow (a measure of excessive daytime sleepiness).
While 19% of the healthy control subjects suffered from excessive daytime sleepiness, 67% of those with TBI did. When they were asked how sleepy they were during the day, those with TBI didn’t report feeling any sleepier than those without TBI.
Lead author Dr. Lukas Imbach, of the University Hospital Zurich, said the study’s findings make a compelling case that sleep-wake disorders after TBI may represent “a silent epidemic.” Long after a patient’s brain appears to have healed, he said, trouble persists.
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