Lower cortical volume is associated with poor sleep quality after traumatic brain injury

2022 ◽  
Author(s):  
Immanuel Babu Henry Samuel ◽  
Kamila U. Pollin ◽  
Charity B. Breneman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Cortical Volume

scholarly journals Screening for Poor Self-Reported Sleep Quality at 12 Weeks in Post-Mild Traumatic Brain Injury Patients Using the HF–Age–Gender (HAG) Index

2021 ◽  
Vol 11 (11) ◽  
pp. 1369
Author(s):  
Hon-Ping Ma ◽  
Ju-Chi Ou ◽  
Kai-Yun Chen ◽  
Kuo-Hsing Liao ◽  
Shuo-Jhen Kang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Mild Traumatic Brain Injury ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Non Invasive ◽  
Patient Will ◽  
Improve Sleep Quality

To identify a screening tool for poor self-reported sleep quality at 12 weeks according to non-invasive measurements and patients’ characteristics in the first week after mild traumatic brain injury (mTBI), data from 473 mTBI participants were collected and follow-ups were performed at 12 weeks. Patients with previous poor self-reported sleep quality prior to the injury were excluded. Patients were then divided into two groups at 12 weeks according to the Pittsburgh Sleep Quality Index based on whether or not they experienced poor sleep quality. The analysis was performed on personal profiles and heart rate variability (HRV) for 1 week. After analyzing the non-invasive measurements and characteristics of mTBI patients who did not complain of poor sleep quality, several factors were found to be relevant to the delayed onset of poor sleep quality, including age, gender, and HRV measurements. The HRV–age–gender (HAG) index was proposed and found to have 100% sensitivity (cut-off, 7; specificity, 0.537) to predicting whether the patient will experience poor sleep quality after mTBI at the 12-week follow-up. The HAG index helps us to identify patients with mTBI who have no sleep quality complaints but are prone to developing poor self-reported sleep quality. Additional interventions to improve sleep quality would be important for these particular patients in the future.

Poor Sleep Quality and Changes in Objectively Recorded Sleep After Traumatic Brain Injury: A Preliminary Study

2008 ◽  
Vol 89 (5) ◽  
pp. 843-850 ◽  
Author(s):  
Diane L. Parcell ◽  
Jennie L. Ponsford ◽  
Jennifer R. Redman ◽  
Shantha M. Rajaratnam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Preliminary Study

020 Sleep Quality Affects the Plasma Exosomal MicroRNA Expression Profile in Military Personnel with Traumatic Brain Injury

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A9-A10
Author(s):  
Sara Mithani ◽  
Jacqueline Leete ◽  
Josephine Pucci ◽  
Viivan Guedes ◽  
Kimbra Kenney ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Military Personnel ◽  
Sleep Disturbances ◽  
Poor Sleep ◽  
Ptsd Symptoms ◽  
Poor Sleep Quality ◽  
Disturbed Sleep ◽  
Exosomal Microrna

Abstract Introduction Disordered sleep is a critical issue facing the US military due to its negative impact on maintaining force readiness, health, and well-being. Traumatic brain injury (TBI) is highly prevalent among military personnel and commonly co-occurs with disturbed sleep: up to 89% of military service members with TBI report poor sleep quality. Disturbed sleep is a hallmark of post-traumatic stress disorder (PTSD), which often coexists with TBI, with upward of 90% of patients with PTSD reporting some form of sleep disturbance. The pathophysiological mechanisms underlying sleep disturbances in TBI patients remain elusive. Exosomal microRNA (exomiRs), which are implicated in intracellular communication, may provide novel insight into molecular networks related to sleep disturbances in TBI patients. Methods ExomiR was extracted from plasma samples of 108 post-9/11 military personnel, and veterans with a history of mild TBI enrolled in a multicenter prospective longitudinal study. ExomiR profiling analysis was conducted using nCounter Human v3 miRNA Expression Panel with 798 microRNA probes. Sleep quality was assessed using the global score on the Pittsburgh Sleep Quality Index (PSQI), and symptoms of PTSD were measured with the PTSD Checklist for DSM-5 (PCL-5). Generalized linear models and Spearman’s correlations were constructed to analyze the relationship between levels of exomiR and global PSQI score. Results We found 17 exomiR that were significantly (P < 0.05) associated with sleep quality and 11 exomiR significantly associated with PTSD symptoms. Two exomiR, has-miR-1268a and has-miR-139-5p, were significantly associated with both sleep quality and PTSD symptoms. The top three significant exomiR associated with sleep quality were hsa-miR-1250-5p (r = 0.2295, p = 0.0171), hsa-miR-3615(r = 0.2207, p = 0.0229), and hsa-miR-122-5p(r = 0.2069, p = 0.0132). Conclusion Overall, these findings suggest that analysis of exosomal miRNA expression may provide novel insights into the underlying pathobiology of sleep quality in military personnel with mild TBI, independent of PTSD symptoms. Further research is needed to understand the biological underpinnings of poor sleep quality in individuals with TBI and to determine causal links. Support (if any) Intramural Research Program at the NINR, Department of Defense, Chronic Effects of Neurotrauma Consortium (CENC) Award W81XWH-13-2-0095 and Department of Veterans Affairs CENC Award I01 CX001135.

A-124 Sleep Quality and Quantity in Individuals Aging with Traumatic Brain Injury: Associations with Psychosocial Outcomes and Health Conditions

2021 ◽  
Vol 36 (6) ◽  
pp. 1174-1174
Author(s):  
Rachael M Riccitello ◽  
Amanda R Rabinowitz ◽  
Umesh M Venkatesan ◽  
Kristine C Dell ◽  
Samantha M Vervoordts ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Chronic Health

Abstract Objective To examine the association of sleep quality/duration with chronic health conditions, psychological distress, and quality of life (QOL) in older adults with chronic traumatic brain injury (TBI). Methods 120 older adults (x-age = 64.2 ± 8.3) 1 or more years (med = 9.8, range = 1.1–45.6) post moderate–severe TBI reported on history of chronic health conditions and current sleep duration and quality. Participants were categorized by sleep duration (< 6, 6–8, >8 hours) and whether or not they felt well-rested. Outcome measures were QOL (Quality of Life after Brain Injury questionnaire) and psychological distress (Brief Symptom Inventory-18). Results 65% of individuals reported receiving 6–8 hours of sleep; 78% reported feeling well-rested. 17.5% reported no health conditions, 47.5% one condition, and 35% reported two or more. High blood pressure, high cholesterol, and diabetes were the most common. Number of health conditions was not related to sleep quality χ2(2,N = 120) =0.83, p = 0.66, or quantity, χ2(4,N = 120) =7.4, p = 0.12. MANCOVA controlling for age, chronicity, and injury severity revealed a significant association between poor sleep quality and decreased QOL across multiple life domains, V = 0.30, F(6,105) = 4.6, p < 0.001, ηp2 = 0.21. Sleep duration was also associated with QOL, Λ = 0.80, F(12,208) = 2.1, p < 0.05, ηp2 = 0.108. In ANCOVAs, poor sleep quality was related to increased psychological distress, F(1,110) = 18.3, p < 0.001, ηp2 = 0.142, but sleep duration was not, F(2,109) = 2.2, p = 0.12, ηp2 = 0.038. Conclusion Although most participants received the recommended amount of sleep, poor sleep quality/quantity were associated with poorer QOL and sleep quality was additionally associated with psychological distress. Chronic health conditions were prevalent in the sample, but not related to self-reported sleep quality/duration.

scholarly journals The relationship between sleep quality, fatigue and psychological wellbeing amongst primary carers for those with brain injury

2018 ◽  
Author(s):  
Maria Gardani
Keyword(s):  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Depression Scale ◽  
Psychological Wellbeing ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Perceived Burden ◽  
Fatigue Severity ◽  
Anxiety Depression

Objectives: The study aimed to investigate possible mediating factors that contribute to poor sleep quality in carers for those with brain injury (BI). More specifically, whether fatigue, anxiety, depression and perceived burden were associated with and/or predicted poor sleep in carers of those with brain injury. Methods: A cross-sectional correlational design was utilised. The Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety Depression Scale (HADS) Fatigue Severity Scale (FSS), Zarit Buren Interview Short (ZBI-12) were completed by 237 carers of people with BI to assess sleep quality, psychological wellbeing and fatigue. Results: Carers demonstrated elevated levels of poor sleep quality, fatigue and poor psychological wellbeing. The results indicated there was a significant relationship between anxiety, depression, perceived burden, fatigue severity and sleep quality. Multiple regression analysis revealed that anxiety, depression, fatigue and burden explained 31.8% of variance in sleep quality. Depression and fatigue were significant predictors of sleep quality with fatigue symptomology being the strongest predictor of poor sleep amongst carers. Conclusion: Psychological wellbeing, perceived burden and fatigue are associated with sleep disturbances in carers with fatigue and depression predicting poor sleep quality. These results provide insight into an under-researched area and emphasise the necessity for support provisions which aim to improve sleep hygiene practices, improve psychological wellbeing and fatigue symptomology.

021 Poor sleep quality in traumatic brain injury patients is associated with elevated inflammatory biomarkers

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A10-A10
Author(s):  
Josephine Pucci ◽  
Sara Mithani ◽  
Jacqueline Leete ◽  
Chen Lai ◽  
Kimbra Kenney ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Protein Quantification ◽  
Model Systems ◽  
Inflammatory Biomarkers ◽  
Poor Sleep ◽  
Type I ◽  
Necrosis Factor Alpha ◽  
Cross Sectional

Abstract Introduction Mild traumatic brain injury (mTBI) and sleep disorders are independently associated with inflammation. Following mTBI, elevated levels of cytokines, such as interleukin-6 (IL-6), 10 (IL-10) and tumor necrosis factor alpha (TNFα), have been observed. These signals are also known to modulate sleep homeostasis. IL-6, IL-10 and TNFα concentrations are typically measured in plasma, but recent work has shown that their measurement in extracellular vesicles (EVs) may hold additional value, as they are shielded from degradation and may be more biologically relevant. We hypothesized that inflammatory biomarkers in chronic mTBI patients would be elevated in poor sleepers. Methods In a cross-sectional cohort of warfighters (n=137 mTBI, 44 controls), the Pittsburgh Sleep Quality Index (PSQI) was compared with EV and plasma IL-6, IL-10, TNFα. Protein quantification was performed with Simoa. Two-tailed tests were used with a type I error of p<0.05. Linear models controlled for age, sex, and body mass index. Results In the mTBI cohort, poor sleepers (PSQI>=10, a published military cutoff) had elevated IL-6 vs. good sleepers (mean [SD] pg/mL, EV: 0.47 [0.63] vs 1.01 [1.54], p=0.04, d=0.44; plasma: 5.00 [13.31] vs 6.88 [13.51], p=0.03, d=0.14). Poor sleepers with mTBI had less EV IL-10 (1.71 [8.18] vs 0.30 [0.54], p=0.017). Comparisons of plasma IL-10 were not significant. No differences in TNFα were observed in mTBI groups. In our model, PSQI was the strongest predictor of EV IL-6 (βstd=0.27, p=0.03) in mTBI patients, whereas only BMI predicted IL-6 in controls. EV IL-6, IL-10, and TNFα correlated with PSQI (R=0.21, p=0.019; R=0.21, p=0.014; R=0.22, p=0.013, respectively), but these relationships were not found with plasma. In controls, no correlations or differences in any biomarker were observed between groups. Conclusion Warfighters who report poor sleep had significantly elevated inflammatory biomarkers after chronic mTBI. Cytokine levels in EVs had greater effect sizes between groups compared to plasma levels suggesting EV measurements may have improved signal. Poor sleep and its association with inflammatory cytokines after mTBI may have therapeutic implications. Support (if any) DoD: Contract W91YTZ-13-C-0015/ HT0014-19-C-0004 with VHA Central Office VA TBI Model Systems Program of Research/DHA Contracting Office (CO-NCR) HT0014

scholarly journals Comprehensive insomnia assessment following mild traumatic brain injury

2021 ◽  
Author(s):  
Dora M. Zalai
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Primary Insomnia ◽  
Chronic Insomnia ◽  
Poor Sleep ◽  
Wake Time ◽  
Insomnia Symptoms

Background and Rationale: Insomnia symptoms following mild traumatic brain injury (mTBI) predict poor TBI outcomes. Insomnia symptoms may be caused by sleep disorders that can be effectively treated, which in turn, may improve mTBI outcomes. Previous studies have focused on insomnia symptom assessment in mTBI or evaluated samples with all TBI severities. To effectively manage insomnia following mTBI, it is important to understand which sleep disorders contribute to insomnia symptoms in this clinical group. Furthermore, it is important to extend research on primary insomnia to determine which variables are related to the perception of poor sleep among individuals who report new onset/worsening insomnia symptoms following mTBI. Objectives: (1) determine the prevalence of sleep disorders that contribute to chronic insomnia symptoms in patients with mTBI and (2) determine which objectively measured electroencephalographic and subjective variables are associated with subjective wake time and the perception of poor sleep among patients with chronic insomnia symptoms following mTBI. Methods: Individuals with chronic insomnia symptoms following mTBI (N = 50; age 17-65; 64% females; 3 - 24 months post mTBI) participated in a multi-method sleep and circadian assessment. Sleep disorders were diagnosed according to ICSD-3 criteria. Results: Insomnia disorder was the most common diagnosis (62%), followed by obstructive sleep apnea (OSA) -44%; circadian rhythm sleep-wake disorders (CRSWD) - 26% and periodic limb movement disorder (PLMD) - 8%. The overestimation of wake time was similar to what has been described in primary insomnia. In contrast to the REM instability hypothesis of primary insomnia, REM sleep duration was not related to subjective wake time. Both low sleep quality and feeling unrested in the morning had the strongest relationship to subjective wake time. Feeling unrested was also associated with anxiety. Conclusions: OSA and CRSWD frequently occur among patients whose main presenting sleep symptom is chronic insomnia following a mTBI. Accordingly, objective sleep and circadian assessment should be part of chronic insomnia evaluation following a mTBI. The results imply that interventions reducing subjective wake time and anxiety could improve subjective sleep quality; however, these interventions should be mplemented in conjunction with the treatment for OSA, CRSWD and PLMD.

scholarly journals Comprehensive insomnia assessment following mild traumatic brain injury

2021 ◽  
Author(s):  
Dora M. Zalai
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Primary Insomnia ◽  
Chronic Insomnia ◽  
Poor Sleep ◽  
Wake Time ◽  
Insomnia Symptoms

Background and Rationale: Insomnia symptoms following mild traumatic brain injury (mTBI) predict poor TBI outcomes. Insomnia symptoms may be caused by sleep disorders that can be effectively treated, which in turn, may improve mTBI outcomes. Previous studies have focused on insomnia symptom assessment in mTBI or evaluated samples with all TBI severities. To effectively manage insomnia following mTBI, it is important to understand which sleep disorders contribute to insomnia symptoms in this clinical group. Furthermore, it is important to extend research on primary insomnia to determine which variables are related to the perception of poor sleep among individuals who report new onset/worsening insomnia symptoms following mTBI. Objectives: (1) determine the prevalence of sleep disorders that contribute to chronic insomnia symptoms in patients with mTBI and (2) determine which objectively measured electroencephalographic and subjective variables are associated with subjective wake time and the perception of poor sleep among patients with chronic insomnia symptoms following mTBI. Methods: Individuals with chronic insomnia symptoms following mTBI (N = 50; age 17-65; 64% females; 3 - 24 months post mTBI) participated in a multi-method sleep and circadian assessment. Sleep disorders were diagnosed according to ICSD-3 criteria. Results: Insomnia disorder was the most common diagnosis (62%), followed by obstructive sleep apnea (OSA) -44%; circadian rhythm sleep-wake disorders (CRSWD) - 26% and periodic limb movement disorder (PLMD) - 8%. The overestimation of wake time was similar to what has been described in primary insomnia. In contrast to the REM instability hypothesis of primary insomnia, REM sleep duration was not related to subjective wake time. Both low sleep quality and feeling unrested in the morning had the strongest relationship to subjective wake time. Feeling unrested was also associated with anxiety. Conclusions: OSA and CRSWD frequently occur among patients whose main presenting sleep symptom is chronic insomnia following a mTBI. Accordingly, objective sleep and circadian assessment should be part of chronic insomnia evaluation following a mTBI. The results imply that interventions reducing subjective wake time and anxiety could improve subjective sleep quality; however, these interventions should be mplemented in conjunction with the treatment for OSA, CRSWD and PLMD.

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