Association of sleep and co-occurring psychological conditions at 1 year after traumatic brain injury

Donald J. Fogelberg, Jeanne M. Hoffman, Sureyya Dikmen, Nancy R. Temkin, Kathleen R. Bell

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objectives: To compare individuals' sleep 1 year after traumatic brain injury (TBI) with that of a healthy comparison group, and examine the relationship between sleep, co-occurring conditions, and functional status in those with TBI. Design: Longitudinal assessment of a prospectively studied sample of individuals with moderate to severe TBI. Assessment of sleep occurred at 1 year after TBI. Setting: Inpatient acute rehabilitation for TBI and community follow-up at 1 year postinjury. Participants: Individuals with TBI (N=174) were recruited from consecutive admissions to an inpatient rehabilitation unit and enrolled into the TBI Model Systems study. Participant mean age was 38, and mean Glasgow Coma Scale score on admission was 9.3. Seventy-eight percent of the sample were men. Interventions: None. Main Outcome Measures: Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI). Depression, anxiety, and pain were measured with the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 Scale, and an analog pain rating scale, respectively. Results: Participants with TBI reported significantly greater sleep difficulties than the healthy comparison group. Forty-four percent of participants with TBI reported significant sleep problems (PSQI>5). Participants with 1 or more co-occurring conditions (depression, pain, or anxiety) had significantly worse sleep than those without such a condition. The highest level of sleep problems was reported by participants with multiple co-occurring conditions. Sleep problems were also associated with poor functional status. Conclusions: Sleep difficulties are a frequent problem at 1 year after TBI, and often co-occur with depression, anxiety, and pain. Assessment and treatment of sleep difficulties should be included in clinical practice. Future research on the potential causal relationship among co-occurring conditions may assist in additional intervention planning.

Original languageEnglish (US)
Pages (from-to)1313-1318
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume93
Issue number8
DOIs
StatePublished - Aug 2012

Fingerprint

Sleep
Psychology
Anxiety
Depression
Pain
Traumatic Brain Injury
Inpatients
Rehabilitation
Glasgow Coma Scale
Pain Measurement
Anxiety Disorders
Outcome Assessment (Health Care)
Health

Keywords

  • Brain injuries
  • Comorbidity
  • Rehabilitation
  • Sleep

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Association of sleep and co-occurring psychological conditions at 1 year after traumatic brain injury. / Fogelberg, Donald J.; Hoffman, Jeanne M.; Dikmen, Sureyya; Temkin, Nancy R.; Bell, Kathleen R.

In: Archives of Physical Medicine and Rehabilitation, Vol. 93, No. 8, 08.2012, p. 1313-1318.

Research output: Contribution to journalArticle

Fogelberg, Donald J. ; Hoffman, Jeanne M. ; Dikmen, Sureyya ; Temkin, Nancy R. ; Bell, Kathleen R. / Association of sleep and co-occurring psychological conditions at 1 year after traumatic brain injury. In: Archives of Physical Medicine and Rehabilitation. 2012 ; Vol. 93, No. 8. pp. 1313-1318.
@article{26e50563cc1a4e5f9ac3100d02be618e,
title = "Association of sleep and co-occurring psychological conditions at 1 year after traumatic brain injury",
abstract = "Objectives: To compare individuals' sleep 1 year after traumatic brain injury (TBI) with that of a healthy comparison group, and examine the relationship between sleep, co-occurring conditions, and functional status in those with TBI. Design: Longitudinal assessment of a prospectively studied sample of individuals with moderate to severe TBI. Assessment of sleep occurred at 1 year after TBI. Setting: Inpatient acute rehabilitation for TBI and community follow-up at 1 year postinjury. Participants: Individuals with TBI (N=174) were recruited from consecutive admissions to an inpatient rehabilitation unit and enrolled into the TBI Model Systems study. Participant mean age was 38, and mean Glasgow Coma Scale score on admission was 9.3. Seventy-eight percent of the sample were men. Interventions: None. Main Outcome Measures: Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI). Depression, anxiety, and pain were measured with the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 Scale, and an analog pain rating scale, respectively. Results: Participants with TBI reported significantly greater sleep difficulties than the healthy comparison group. Forty-four percent of participants with TBI reported significant sleep problems (PSQI>5). Participants with 1 or more co-occurring conditions (depression, pain, or anxiety) had significantly worse sleep than those without such a condition. The highest level of sleep problems was reported by participants with multiple co-occurring conditions. Sleep problems were also associated with poor functional status. Conclusions: Sleep difficulties are a frequent problem at 1 year after TBI, and often co-occur with depression, anxiety, and pain. Assessment and treatment of sleep difficulties should be included in clinical practice. Future research on the potential causal relationship among co-occurring conditions may assist in additional intervention planning.",
keywords = "Brain injuries, Comorbidity, Rehabilitation, Sleep",
author = "Fogelberg, {Donald J.} and Hoffman, {Jeanne M.} and Sureyya Dikmen and Temkin, {Nancy R.} and Bell, {Kathleen R.}",
year = "2012",
month = "8",
doi = "10.1016/j.apmr.2012.04.031",
language = "English (US)",
volume = "93",
pages = "1313--1318",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - Association of sleep and co-occurring psychological conditions at 1 year after traumatic brain injury

AU - Fogelberg, Donald J.

AU - Hoffman, Jeanne M.

AU - Dikmen, Sureyya

AU - Temkin, Nancy R.

AU - Bell, Kathleen R.

PY - 2012/8

Y1 - 2012/8

N2 - Objectives: To compare individuals' sleep 1 year after traumatic brain injury (TBI) with that of a healthy comparison group, and examine the relationship between sleep, co-occurring conditions, and functional status in those with TBI. Design: Longitudinal assessment of a prospectively studied sample of individuals with moderate to severe TBI. Assessment of sleep occurred at 1 year after TBI. Setting: Inpatient acute rehabilitation for TBI and community follow-up at 1 year postinjury. Participants: Individuals with TBI (N=174) were recruited from consecutive admissions to an inpatient rehabilitation unit and enrolled into the TBI Model Systems study. Participant mean age was 38, and mean Glasgow Coma Scale score on admission was 9.3. Seventy-eight percent of the sample were men. Interventions: None. Main Outcome Measures: Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI). Depression, anxiety, and pain were measured with the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 Scale, and an analog pain rating scale, respectively. Results: Participants with TBI reported significantly greater sleep difficulties than the healthy comparison group. Forty-four percent of participants with TBI reported significant sleep problems (PSQI>5). Participants with 1 or more co-occurring conditions (depression, pain, or anxiety) had significantly worse sleep than those without such a condition. The highest level of sleep problems was reported by participants with multiple co-occurring conditions. Sleep problems were also associated with poor functional status. Conclusions: Sleep difficulties are a frequent problem at 1 year after TBI, and often co-occur with depression, anxiety, and pain. Assessment and treatment of sleep difficulties should be included in clinical practice. Future research on the potential causal relationship among co-occurring conditions may assist in additional intervention planning.

AB - Objectives: To compare individuals' sleep 1 year after traumatic brain injury (TBI) with that of a healthy comparison group, and examine the relationship between sleep, co-occurring conditions, and functional status in those with TBI. Design: Longitudinal assessment of a prospectively studied sample of individuals with moderate to severe TBI. Assessment of sleep occurred at 1 year after TBI. Setting: Inpatient acute rehabilitation for TBI and community follow-up at 1 year postinjury. Participants: Individuals with TBI (N=174) were recruited from consecutive admissions to an inpatient rehabilitation unit and enrolled into the TBI Model Systems study. Participant mean age was 38, and mean Glasgow Coma Scale score on admission was 9.3. Seventy-eight percent of the sample were men. Interventions: None. Main Outcome Measures: Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI). Depression, anxiety, and pain were measured with the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 Scale, and an analog pain rating scale, respectively. Results: Participants with TBI reported significantly greater sleep difficulties than the healthy comparison group. Forty-four percent of participants with TBI reported significant sleep problems (PSQI>5). Participants with 1 or more co-occurring conditions (depression, pain, or anxiety) had significantly worse sleep than those without such a condition. The highest level of sleep problems was reported by participants with multiple co-occurring conditions. Sleep problems were also associated with poor functional status. Conclusions: Sleep difficulties are a frequent problem at 1 year after TBI, and often co-occur with depression, anxiety, and pain. Assessment and treatment of sleep difficulties should be included in clinical practice. Future research on the potential causal relationship among co-occurring conditions may assist in additional intervention planning.

KW - Brain injuries

KW - Comorbidity

KW - Rehabilitation

KW - Sleep

UR - http://www.scopus.com/inward/record.url?scp=84864348883&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864348883&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2012.04.031

DO - 10.1016/j.apmr.2012.04.031

M3 - Article

C2 - 22840828

AN - SCOPUS:84864348883

VL - 93

SP - 1313

EP - 1318

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 8

ER -