Insomnia, fatigue, and sleepiness in the first 2 years after traumatic brain injury: An NIDRR TBI model system module study

Joshua B. Cantor, Tamara Bushnik, Keith Cicerone, Marcel P. Dijkers, Wayne Gordon, Flora Hammond, Stephanie A. Kolakowsky-Hayner, Anthony Lequerica, Michael Nguyen, Lisa A. Spielman

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

OBJECTIVE: To determine the prevalence of insomnia and posttraumatic brain injury (TBI) fatigue (PTBIF) in individuals with moderate to severe TBI, to explore the relationship between PTBIF and insomnia and their association with outcomes. DESIGN: Cross-sectional study. SETTING: Five National Institute of Disability and Rehabilitation Research TBI Model Systems. PARTICIPANTS: Three hundred thirty-four individuals with TBI who completed 1-year (n = 213) or 2-year (n = 121) follow-up interviews between 2008 and 2012. MAIN OUTCOME RESULTS: Insomnia occurred in 11% to 24% and PTBIF in 33% to 44% of the individuals. Insomnia and fatigue were both related to sleep disturbance, sleep hygiene, satisfaction with life, anxiety, and depression. PTBIF was associated with greater disability and sleepiness. Insomnia without fatigue was rare (2%-3%) but PTBIF without insomnia occurred in 21% to 23% of the individuals. Comorbidity occurred in 9% to 22% of the individuals. CONCLUSIONS: Although PTBIF and insomnia are closely related and both associated with poorer quality of life, they are affected independently by a variety of factors, especially psychopathology and sleep quality. A majority of individuals with PTBIF do not have insomnia; and PTBIF appears to be related to disability severity and daytime sleepiness, where insomnia is not. Demographic and injury variables are not strong predictors of insomnia or PTBIF.

Original languageEnglish
JournalJournal of Head Trauma Rehabilitation
Volume27
Issue number6
DOIs
StatePublished - Nov 2012

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Sleep Initiation and Maintenance Disorders
Fatigue
Sleep
Traumatic Brain Injury
Psychopathology
Brain Injuries
Comorbidity
Anxiety
Cross-Sectional Studies
Quality of Life
Demography
Interviews
Depression
Wounds and Injuries

Keywords

  • chronic brain injury
  • comorbidity
  • fatigue
  • insomnia
  • sleep
  • traumatic brain injury

ASJC Scopus subject areas

  • Rehabilitation
  • Clinical Neurology
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Insomnia, fatigue, and sleepiness in the first 2 years after traumatic brain injury : An NIDRR TBI model system module study. / Cantor, Joshua B.; Bushnik, Tamara; Cicerone, Keith; Dijkers, Marcel P.; Gordon, Wayne; Hammond, Flora; Kolakowsky-Hayner, Stephanie A.; Lequerica, Anthony; Nguyen, Michael; Spielman, Lisa A.

In: Journal of Head Trauma Rehabilitation, Vol. 27, No. 6, 11.2012.

Research output: Contribution to journalArticle

Cantor, JB, Bushnik, T, Cicerone, K, Dijkers, MP, Gordon, W, Hammond, F, Kolakowsky-Hayner, SA, Lequerica, A, Nguyen, M & Spielman, LA 2012, 'Insomnia, fatigue, and sleepiness in the first 2 years after traumatic brain injury: An NIDRR TBI model system module study', Journal of Head Trauma Rehabilitation, vol. 27, no. 6. https://doi.org/10.1097/HTR.0b013e318270f91e
Cantor, Joshua B. ; Bushnik, Tamara ; Cicerone, Keith ; Dijkers, Marcel P. ; Gordon, Wayne ; Hammond, Flora ; Kolakowsky-Hayner, Stephanie A. ; Lequerica, Anthony ; Nguyen, Michael ; Spielman, Lisa A. / Insomnia, fatigue, and sleepiness in the first 2 years after traumatic brain injury : An NIDRR TBI model system module study. In: Journal of Head Trauma Rehabilitation. 2012 ; Vol. 27, No. 6.
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AU - Cicerone, Keith

AU - Dijkers, Marcel P.

AU - Gordon, Wayne

AU - Hammond, Flora

AU - Kolakowsky-Hayner, Stephanie A.

AU - Lequerica, Anthony

AU - Nguyen, Michael

AU - Spielman, Lisa A.

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N2 - OBJECTIVE: To determine the prevalence of insomnia and posttraumatic brain injury (TBI) fatigue (PTBIF) in individuals with moderate to severe TBI, to explore the relationship between PTBIF and insomnia and their association with outcomes. DESIGN: Cross-sectional study. SETTING: Five National Institute of Disability and Rehabilitation Research TBI Model Systems. PARTICIPANTS: Three hundred thirty-four individuals with TBI who completed 1-year (n = 213) or 2-year (n = 121) follow-up interviews between 2008 and 2012. MAIN OUTCOME RESULTS: Insomnia occurred in 11% to 24% and PTBIF in 33% to 44% of the individuals. Insomnia and fatigue were both related to sleep disturbance, sleep hygiene, satisfaction with life, anxiety, and depression. PTBIF was associated with greater disability and sleepiness. Insomnia without fatigue was rare (2%-3%) but PTBIF without insomnia occurred in 21% to 23% of the individuals. Comorbidity occurred in 9% to 22% of the individuals. CONCLUSIONS: Although PTBIF and insomnia are closely related and both associated with poorer quality of life, they are affected independently by a variety of factors, especially psychopathology and sleep quality. A majority of individuals with PTBIF do not have insomnia; and PTBIF appears to be related to disability severity and daytime sleepiness, where insomnia is not. Demographic and injury variables are not strong predictors of insomnia or PTBIF.

AB - OBJECTIVE: To determine the prevalence of insomnia and posttraumatic brain injury (TBI) fatigue (PTBIF) in individuals with moderate to severe TBI, to explore the relationship between PTBIF and insomnia and their association with outcomes. DESIGN: Cross-sectional study. SETTING: Five National Institute of Disability and Rehabilitation Research TBI Model Systems. PARTICIPANTS: Three hundred thirty-four individuals with TBI who completed 1-year (n = 213) or 2-year (n = 121) follow-up interviews between 2008 and 2012. MAIN OUTCOME RESULTS: Insomnia occurred in 11% to 24% and PTBIF in 33% to 44% of the individuals. Insomnia and fatigue were both related to sleep disturbance, sleep hygiene, satisfaction with life, anxiety, and depression. PTBIF was associated with greater disability and sleepiness. Insomnia without fatigue was rare (2%-3%) but PTBIF without insomnia occurred in 21% to 23% of the individuals. Comorbidity occurred in 9% to 22% of the individuals. CONCLUSIONS: Although PTBIF and insomnia are closely related and both associated with poorer quality of life, they are affected independently by a variety of factors, especially psychopathology and sleep quality. A majority of individuals with PTBIF do not have insomnia; and PTBIF appears to be related to disability severity and daytime sleepiness, where insomnia is not. Demographic and injury variables are not strong predictors of insomnia or PTBIF.

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KW - comorbidity

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