Rehabilitation is compromised by arousal and sleep disorders: Results of a survey of rehabilitation centres

Abstract

Long-term outcome from severe brain injury can be compromised by enduring disturbance of arousal, most commonly evidenced as sleep disorder. Treatment should be based on judicious use of medication (beyond hypnotic drugs) and greater emphasis on non-pharmacological management.

Sleepiness and fatigue following traumatic brain injury

“…Sleepiness may present as a stand-alone symptom or as part of a sleep disorder such as sleep apnea, narcolepsy, or posttraumatic hypersomnia [3,7]. In many cases, sleep-wake disturbances are directly related to the brain trauma, persist for months or years after the injury, and may impede the recovery process and return to premorbid functioning [3,8,9]. Fatigue is also a very common symptom following TBI, with prevalence estimates ranging from 43% to 73% by self-report [10].…”

Characterizing Self-Reported Sleep Disturbance after Mild Traumatic Brain Injury

“…Although the base rate of such complaints is high in the general population, 4 it is possible that when they occur after mTBI, they indicate sleep disturbance sufficient to worsen physical and mental recovery. [5][6][7][8] For example, sleep disturbance could: contribute to or exacerbate comorbid conditions such as depression, fatigue and pain 1,9 ; worsen recovery because the normal restorative and recuperative functions of sleep are disrupted 3 ; interfere directly with rehabilitation 5 ; or signal ongoing disruption of neurophysiological processes. 6,10,11 It is possible that sleep disturbance before the TBI is also a contributor to poor outcome by increasing vulnerability or reducing recovery capacity.…”

Sleep Disorders Associated With Mild Traumatic Brain Injury Using Sport Concussion Assessment Tool 3

“…14 Sleep disruption has been shown to hinder overall rehabilitation from TBI and is suggested to have a negative effect on the neural remodeling necessary for recovery from many types of brain injuries. 15 Assessment of concussion can be a challenging endeavor for medical practitioners given the different factors associated with each individual injury. Traditionally, clinicians have had to rely on subjective reports of athletes to determine the status regarding M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 8 recovery from the concussion.…”