Sleep Disorders in Traumatic Brain Injury

Jacob F. Collen, MD; Christopher J. Lettieri, MD


May 24, 2011

In This Article

Comorbid Mood Disorders

Mood disorders are common in patients with TBI, especially in those with combat-related trauma. These conditions, particularly depression and PTSD, have a significant cause-and-effect relationship with sleep disorders. Moreover, the presence of sleep disorders in patients with PTSD or depression is associated with a diminished response to therapy and greater symptoms. As such, it would appear that the combination of both a mood and sleep disorder in an individual with a TBI would portend worse outcomes. Rao and coworkers assessed 54 patients with closed head injuries for risk factors for the development of sleep disorders.[23] The investigators found that anxiety disorders developing post-injury were more significant predictors of sleep disruption than pain, comorbid diseases, or medication adverse effects. Similarly, in a clinical study of individuals with TBI, Shekleton found that these patients had significantly more anxiety, depression, and sleep disruptions than controls.[24]


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