Study of fatigue and associated factors in traumatic brain injury and its correlation with insomnia and depression

Abstract

Introduction:Fatigue has been cited as a common problem associated with traumatic brain injury. A positive association of fatigue has been suggested with insomnia and depression which are also considered to be significantly associated with traumatic brain injury.Aims and Objectives:The present study in post-traumatic brain injury patients is planned to assess the prevalence of fatigue, depression and insomnia, the correlation of fatigue with depression and insomnia and the risk factors associated with fatigue.Material and Methodology:Total 100 patients were recruited in the present study. Interview was focused on assessment of severity of traumatic brain injury, fatigue, insomnia and depression using Glasgow Coma Scale, Fatigue Severity Scale, Insomnia Severity Index and Patients Health Questionnaire(PHQ-9) respectively.Results:Prevalence of depression was found 84% while that of fatigue and insomnia was 50% and 49% respectively. All patients with fatigue had depression whereas those patients without fatigue were also found to have depression (68%) and this correlation was found statistically significant. Similarly, insomnia was reported in 70% of patients who were fatigued against 28% of patients with no fatigue. This was also found statistically significant (P <0.0002).Conclusion:Fatigue in common in post TBI patients. Insomnia and depression are closely associated with fatigue. Clinical and research investigations of fatigue in post-traumatic brain injury should include concomitant screening for treatable depressive symptoms and sleep disorders.

Clinical Concerns in Counseling Clients with Traumatic Brain Injury

“…The authors then went on to explore any correlation insomnia and depression since fatigue has been linked to those disorders. With 100 patients, the authors found that the prevalence of depression was in 84%, while fatigue and insomnia was 50% and 49% respectively [9]. The findings were concrete as in fatigue is common in post TBI patients.…”

“…Rehabilitation is often a problematic endeavor as the person with a head injury may present with multiple concerns, thus making rehabilitation, and recovery difficult and problematic [10]. This paper has attempted to provide more in depth analysis and build on the work of Maucieri [11] in attempting to assist counselors working with individuals with open or closed head injury or perhaps severe concussion.…”

“…Insomnia and depression are closely associated with fatigue. Clinical and research investigations of fatigue in post-traumatic brain injury should include screening for treatable depressive symptoms and sleep disorders [9]. These cursorily reviewed articles indicate some of the affects and symptoms of what TBI's can do.…”

The interaction of the circadian and immune system: Desynchrony as a pathological outcome to traumatic brain injury

“…Further, therapies that focus on sleep hygiene and light therapy have had some success in treating TBI-induced sleep disorders ( Barshikar and Bell, 2017 ). One particular study found that insomnia and depression post-TBI was associated with the fatigue caused by diffuse axonal injury and impairments in information processing ( Tomar et al, 2018 ). The high incidence of reported sleep problems following TBI could therefore be a result of circadian desynchrony brought about by damage to SCN input pathways, or immune system changes to clock gene expression.…”

Efficacy and acceptability of blue-wavelength light therapy for post-TBI behavioral symptoms: A systematic review and meta-analysis of randomized controlled trials

“…This therapy can reduce depressive symptoms in seasonal and non-seasonal affective disorders, as well as fatigue and sleepiness in seasonal affective disorder (SAD) [ 14 – 16 ]. Post-TBI depressive symptoms, fatigue, and sleep abnormalities are highly correlated [ 17 ], and this symptom cluster is relatively similar to the symptoms of SAD. Among all visible light wavelengths, blue/short wavelengths (λ = 400–490 nm) are the most potent synchronizing agent for altering physiological functions, particularly circadian rhythm [ 18 , 19 ].…”