Insomnia in the context of traumatic brain injury

Zeitzer, Jamie M.; Friedman, Leah; O’Hara, Ruth

doi:10.1682/jrrd.2008.08.0099

Cited by 88 publications

(56 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Objective differences in WASO, however, have not been consistently demonstrated, 19,45,47 suggesting a need for further investigation, because the subjective experience of insomnia is central to its diagnosis. 48 Results from the ISI in this study indicate that higher distress because of poor sleep was experienced by the mTBI participants compared with controls; on average, the mTBI group reported clinically significant moderate insomnia whereas controls reported subthreshold insomnia. 30 The SOL result was inconsistent with the findings from previous studies; it was not different for mTBI participants and controls.…”

Section: Discussionmentioning

confidence: 62%

Characterizing Self-Reported Sleep Disturbance after Mild Traumatic Brain Injury

Sullivan

Edmed²,

Allan³

et al. 2015

Journal of Neurotrauma

View full text Add to dashboard Cite

Sleep disturbance after mild traumatic brain injury (mTBI) is commonly reported as debilitating and persistent. However, the nature of this disturbance is poorly understood. This study sought to characterize sleep after mTBI compared with a control group. A cross-sectional matched case control design was used. Thirty-three persons with recent mTBI (1-6 months ago) and 33 age, sex, and ethnicity matched controls completed established questionnaires of sleep quality, quantity, timing, and sleep-related daytime impairment. The mTBI participants were compared with an independent sample of close-matched controls (CMCs; n = 33) to allow partial internal replication. Compared with controls, persons with mTBI reported significantly greater sleep disturbance, more severe insomnia symptoms, a longer duration of wake after sleep onset, and greater sleep-related impairment (all medium to large effects, Cohen's d > 0.5). No differences were found in sleep quantity, timing, sleep onset latency, sleep efficiency, or daytime sleepiness. All findings except a measure of sleep timing (i.e., sleep midpoint) were replicated for CMCs. These results indicate a difference in the magnitude and nature of perceived sleep disturbance after mTBI compared with controls, where persons with mTBI report poorer sleep quality and greater sleep-related impairment. Sleep quantity and timing did not differ between the groups. These preliminary findings should guide the provision of clearer advice to patients about the aspects of their sleep that may change after mTBI and could inform treatment selection.

show abstract

Section: Discussionmentioning

confidence: 62%

Characterizing Self-Reported Sleep Disturbance after Mild Traumatic Brain Injury

Sullivan

Edmed²,

Allan³

et al. 2015

Journal of Neurotrauma

View full text Add to dashboard Cite

show abstract

“…65 Sleep disturbances are common following traumatic brain injury [66][67][68][69][70][71] and occur frequently in veterans who have sustained TBI. 54,66,72,73 A large epidemiological study of 29,640 military members with blast-related TBI showed that sleep disturbances mediate subsequent development of PTSD and depression. 74 Because TBI, PTSD, and depression have overlapping symptoms, particularly symptoms associated with sleep problems, it is difficult to know whether the presence of one condition is a precursor to another.…”

Section: Discussionmentioning

confidence: 99%

“…This enzyme is involved in the conversion of serotonin to the circadian hormone melatonin. 53 This finding is of particular interest given the prevalence of sleep disturbance 54 and depression 4 in individuals with TBI. Reduced salivary melatonin levels also have been reported in TBI patients.…”

Section: Figmentioning

confidence: 90%

Neuronal DNA Methylation Profiling of Blast-Related Traumatic Brain Injury

Haghighi

Chen

et al. 2015

Journal of Neurotrauma

View full text Add to dashboard Cite

Long-term molecular changes in the brain resulting from blast exposure may be mediated by epigenetic changes, such as deoxyribonucleic acid (DNA) methylation, that regulate gene expression. Aberrant regulation of gene expression is associated with behavioral abnormalities, where DNA methylation bridges environmental signals to sustained changes in gene expression. We assessed DNA methylation changes in the brains of rats exposed to three 74.5 kPa blast overpressure events, conditions that have been associated with long-term anxiogenic manifestations weeks or months following the initial exposures. Rat frontal cortex eight months post-exposure was used for cell sorting of whole brain tissue into neurons and glia. We interrogated DNA methylation profiles in these cells using Expanded Reduced Representation Bisulfite Sequencing. We obtained data for millions of cytosines, showing distinct methylation profiles for neurons and glia and an increase in global methylation in neuronal versus glial cells ( p < 10 -7 ). We detected DNA methylation perturbations in blast overpressure-exposed animals, compared with sham blast controls, within 458 and 379 genes in neurons and glia, respectively. Differentially methylated neuronal genes showed enrichment in cell death and survival and nervous system development and function, including genes involved in transforming growth factor b and nitric oxide signaling. Functional validation via gene expression analysis of 30 differentially methylated neuronal and glial genes showed a 1.2 fold change in gene expression of the serotonin N-acetyltransferase gene (Aanat) in blast animals ( p < 0.05). These data provide the first genome-based evidence for changes in DNA methylation induced in response to multiple blast overpressure exposures. In particular, increased methylation and decreased gene expression were observed in the Aanat gene, which is involved in converting serotonin to the circadian hormone melatonin and is implicated in sleep disturbance and depression associated with traumatic brain injury.

show abstract

“…The prevalence of insomnia following TBI is varied, with anywhere from 10 to 84% of patients reporting insomnia symptoms up to three years following injury (Chan and Feinstein 2015;Pillar et al 2003;Hou et al 2013;Viola-Saltzman and Musleh 2016;Zeitzer et al 2009;Kempf et al 2010). One small prospective study, however, found insomnia occurring in only three of 65 patients using actigraphy and PSG (Baumann et al 2007).…”

Section: Insomniamentioning

confidence: 99%

A review of sleep disturbances following traumatic brain injury

Zuzuárregui

Bickart

Kutscher

2018

Sleep Science Practice

View full text Add to dashboard Cite

Background: Sleep disorders are common following traumatic brain injury (TBI). Methods: We review the literature regarding sleep disturbances in the acute and chronic phase following TBI in both the adult and pediatric population. Results: Acute and chronic disruption of sleep commonly follows TBI and contributes to morbidity commonly seen post-injury in both adults and children. This includes the direct effect of TBI leading to sleep disruption, as well as sleep disorders resulting from TBI itself. Pre-TBI neurocognitive testing is important to determine a baseline prior to injury, while disrupted sleep can also prolong recovery after TBI. Early recognition of sleep disturbances post-injury can lead to earlier treatment and limit the sequelae of TBI, as well as assist in recovery. Conclusion: We suggest that evaluation for sleep disturbances following TBI is a critical component of post-TBI assessment and management.

show abstract

Insomnia in the context of traumatic brain injury

Cited by 88 publications

References 68 publications

Characterizing Self-Reported Sleep Disturbance after Mild Traumatic Brain Injury

Characterizing Self-Reported Sleep Disturbance after Mild Traumatic Brain Injury

Neuronal DNA Methylation Profiling of Blast-Related Traumatic Brain Injury

A review of sleep disturbances following traumatic brain injury

Contact Info

Product

Resources

About