Factors associated with the remission of insomnia after traumatic brain injury: a traumatic brain injury model systems study

Anthony H. Lequerica, Erica Weber, Marcel P. Dijkers, Kristen Dams-O’Connor, Stephanie A. Kolakowsky-Hayner, Kathleen R. Bell, Tamara Bushnik, Yelena Goldin, Flora M. Hammond

Research output: Contribution to journalArticle

Abstract

Objective: To examine the factors associated with the remission of insomnia by examining a sample of individuals who had insomnia within the first two years after traumatic brain injury (TBI) and assessing their status at a secondary time point. Design and Methods: Secondary data analysis from a multicenter longitudinal cohort study. A sample of 40 individuals meeting inclusion criteria completed a number of self-report scales measuring sleep/wake characteristics (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Insomnia Severity Index, Sleep Hygiene Index), fatigue and depression (Multidimensional Assessment of Fatigue, Patient Health Questionnaire-9), and community participation (Participation Assessment with Recombined Tools-Objective). One cohort was followed at 1 and 2 years post-injury (n = 19) while a second cohort was followed at 2 and 5 years post-injury (n = 21). Results: Remission of insomnia was noted in 60% of the sample. Those with persistent insomnia had significantly higher levels of fatigue and depression at their final follow-up and poorer sleep hygiene across both follow-up time-points. A trend toward reduced community participation among those with persistent insomnia was also found. Conclusion: Individuals with persistent post-TBI insomnia had poorer psychosocial outcomes. The chronicity of post-TBI insomnia may be associated with sleep-related behaviors that serve as perpetuating factors.

Original languageEnglish (US)
JournalBrain Injury
DOIs
StateAccepted/In press - Jan 1 2019

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Sleep Initiation and Maintenance Disorders
Fatigue
Sleep
Depression
Traumatic Brain Injury
Wounds and Injuries
Self Report
Longitudinal Studies
Cohort Studies
Health

Keywords

  • insomnia
  • sleep disturbance
  • Traumatic brain injury

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology

Cite this

Factors associated with the remission of insomnia after traumatic brain injury : a traumatic brain injury model systems study. / Lequerica, Anthony H.; Weber, Erica; Dijkers, Marcel P.; Dams-O’Connor, Kristen; Kolakowsky-Hayner, Stephanie A.; Bell, Kathleen R.; Bushnik, Tamara; Goldin, Yelena; Hammond, Flora M.

In: Brain Injury, 01.01.2019.

Research output: Contribution to journalArticle

Lequerica, Anthony H. ; Weber, Erica ; Dijkers, Marcel P. ; Dams-O’Connor, Kristen ; Kolakowsky-Hayner, Stephanie A. ; Bell, Kathleen R. ; Bushnik, Tamara ; Goldin, Yelena ; Hammond, Flora M. / Factors associated with the remission of insomnia after traumatic brain injury : a traumatic brain injury model systems study. In: Brain Injury. 2019.
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abstract = "Objective: To examine the factors associated with the remission of insomnia by examining a sample of individuals who had insomnia within the first two years after traumatic brain injury (TBI) and assessing their status at a secondary time point. Design and Methods: Secondary data analysis from a multicenter longitudinal cohort study. A sample of 40 individuals meeting inclusion criteria completed a number of self-report scales measuring sleep/wake characteristics (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Insomnia Severity Index, Sleep Hygiene Index), fatigue and depression (Multidimensional Assessment of Fatigue, Patient Health Questionnaire-9), and community participation (Participation Assessment with Recombined Tools-Objective). One cohort was followed at 1 and 2 years post-injury (n = 19) while a second cohort was followed at 2 and 5 years post-injury (n = 21). Results: Remission of insomnia was noted in 60{\%} of the sample. Those with persistent insomnia had significantly higher levels of fatigue and depression at their final follow-up and poorer sleep hygiene across both follow-up time-points. A trend toward reduced community participation among those with persistent insomnia was also found. Conclusion: Individuals with persistent post-TBI insomnia had poorer psychosocial outcomes. The chronicity of post-TBI insomnia may be associated with sleep-related behaviors that serve as perpetuating factors.",
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