Sleep complications following traumatic brain injury.

ABSTRACT

PURPOSE OF REVIEW Recent research has provided extensive characterization as to the frequency and nature of sleep disturbances following traumatic brain injury (TBI). This review summarizes the current state of knowledge and proposes future directions for research. RECENT FINDINGS: Complaints of sleep disturbance are common following TBI, and objective assessments of sleep largely corroborate these complaints. Sleep is often disturbed in the acute phase postinjury and can persist for decades, with the prevalence of sleep disorders higher in patients with TBI as compared with the general population. The factors causing sleep disturbance appear to involve numerous interrelated primary and secondary factors, including direct damage to vital sleep-regulating regions of the brain, alterations in the circadian system, lowered mood as well as increased anxiety and pain. The complex web of contributing factors implies that combination therapies targeting a number of putative causal mechanisms may yield the greatest success in terms of improving sleep postinjury. SUMMARY: Sleep disturbance is a common consequence of TBI. Research is needed to ascertain the primary drivers of sleep disturbance postinjury to guide the development of targeted interventions. In the absence of a single mechanism, combination therapies may prove most fruitful.