This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Makley, M. J. Articles by Tarwater, P. M. Search for Related Content PubMed PubMed Citation Articles by Makley, M. J. Articles by Tarwater, P. M. Social Bookmarking                         What's this?

Prevalence of Sleep Disturbance in Closed Head Injury Patients in a Rehabilitation Unit

University of Maryland School of Medicine, Baltimore, mmakley{at}kernan.umm.edu

J. B. English, MD

Neurology, MS Center of Atlanta, Georgia

D. A. Drubach, MD

Neurology, Mayo Clinic, Rochester, Minnesota

A. J. Kreuz, PhD

Biology, Villa Julie College, Baltimore, Maryland

P. A. Celnik, MD

Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland

P. M. Tarwater, PhD

Biostatistics, University of Texas School of Public Health, Houston

Traumatic brain injury (TBI) is a leading cause of disability in young people in the United States. Disorders of arousal and attention are common in closed head injury (CHI). Daytime drowsiness impairs participation in rehabilitation, whereas nighttime wakefulness leads to falls and behavioral disturbances. Sleep disturbances in TBI reported in the literature have included excessive daytime somnolence, sleep phase cycle disturbance, narcolepsy, and sleep apnea. Although well known to the clinician treating these patients, the extent and prevalence of disrupted sleep in patients in an acute inpatient rehabilitation unit has not been described. Objective. To determine the prevalence of sleep wake cycle disturbance (SWCD) in patients with CHI in a TBI rehabilitation unit. Design. Prospective observational. Setting. Inpatient specialized brain injury rehabilitation unit. Patients. Thirty-one consecutive admissions to a brain injury rehabilitation unit with the diagnosis of CHI. Results. Twenty-one patients (68%) had aberrations of nighttime sleep. There was no significant difference in Glasgow Coma Score on admission to trauma nor was there any significant difference in age between the affected and unaffected groups. Patients with SWCD had longer stays in both the trauma center (P < .003) and the rehabilitation center (P < .03). Conclusions. There is a high prevalence of SWCD in CHI patients admitted to a brain injury rehabilitation unit. Patients with SWCD have longer stays in both acute and rehabilitation settings and may be a marker for more severe injury.

Key Words: Brain injury • Trauma • Sleep disturbance • Memory • Amnesia • Circadian disorder.

Neurorehabilitation and Neural Repair, Vol. 22, No. 4, 341-347 (2008)
DOI: 10.1177/1545968308315598


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				Y.-H. Kim, W.-K. Yoo, M.-H. Ko, C.-h. Park, Sung Tae Kim, and D. L. Na Plasticity of the Attentional Network After Brain Injury and Cognitive Rehabilitation Neurorehabil Neural Repair, June 1, 2009; 23(5): 468 - 477. [Abstract] [PDF]

				M. J. Makley, L. Johnson-Greene, P. M. Tarwater, A. J. Kreuz, J. Spiro, V. Rao, and P. A. Celnik Return of Memory and Sleep Efficiency Following Moderate to Severe Closed Head Injury Neurorehabil Neural Repair, May 1, 2009; 23(4): 320 - 326. [Abstract] [PDF]