scholarly journals Sleep, Sleep Disorders, and Mild Traumatic Brain Injury. What We Know and What We Need to Know: Findings from a National Working Group

2016 ◽  
Vol 13 (2) ◽  
pp. 403-417 ◽  
Author(s):  
Emerson M. Wickwire ◽  
Scott G. Williams ◽  
Thomas Roth ◽  
Vincent F. Capaldi ◽  
Michael Jaffe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Working Group

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.

scholarly journals Sleep, Sleep Disorders, and Circadian Health following Mild Traumatic Brain Injury in Adults: Review and Research Agenda

2018 ◽  
Vol 35 (22) ◽  
pp. 2615-2631 ◽  
Author(s):  
Emerson M. Wickwire ◽  
David M. Schnyer ◽  
Anne Germain ◽  
Michael T. Smith ◽  
Scott G. Williams ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Research Agenda

Circadian rhythm sleep disorders following mild traumatic brain injury

Neurology ◽  
2007 ◽  
Vol 68 (14) ◽  
pp. 1136-1140 ◽  
Author(s):  
L. Ayalon ◽  
K. Borodkin ◽  
L. Dishon ◽  
H. Kanety ◽  
Y. Dagan
Keyword(s):  
Traumatic Brain Injury ◽  
Circadian Rhythm ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Circadian Rhythm Sleep Disorders

scholarly journals 0904 Sleep Disorders in Veterans with Mild Traumatic Brain Injury

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A363-A363
Author(s):  
Lissette Jimenez ◽  
Aslee Sierra-Gonzalez ◽  
Marlene Colón-Feliciano ◽  
Nashaly Khaffage-Abuomar ◽  
Gerardo Jovet ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury

Sleep Disorders Associated With Mild Traumatic Brain Injury Using Sport Concussion Assessment Tool 3

2016 ◽  
Vol 57 ◽  
pp. 46-50.e1 ◽  
Author(s):  
Nataliya Tkachenko ◽  
Kanwaljit Singh ◽  
Lisena Hasanaj ◽  
Liliana Serrano ◽  
Sanjeev V. Kothare
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Mild Traumatic Brain Injury ◽  
Assessment Tool ◽  
Sport Concussion

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

Assessment of Cognitive-Communicative Disorders of Mild Traumatic Brain Injury Sustained in Combat

2009 ◽  
Vol 19 (2) ◽  
pp. 47-57 ◽  
Author(s):  
Christine Parrish ◽  
Carole Roth ◽  
Brooke Roberts ◽  
Gail Davie
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Psychological Health ◽  
Communication Disorders ◽  
Service Members ◽  
Patient Questionnaire ◽  
Speech Language Pathologists ◽  
Test Protocol ◽  
Communication Deficits

Abstract Background: Mild traumatic brain injury (mTBI) is recognized as the signature injury of the current conflicts in Iraq and Afghanistan, yet there remains limited understanding of the persisting cognitive deficits of mTBI sustained in combat. Speech-language pathologists (SLPs) have traditionally been responsible for evaluating and treating the cognitive-communication disorders following severe brain injuries. The evaluation instruments historically used are insensitive to the subtle deficits found in individuals with mTBI. Objectives: Based on the limited literature and clinical evidence describing traditional and current tests for measuring cognitive-communication deficits (CCD) of TBI, the strengths and weaknesses of the instruments are discussed relative to their use with mTBI. It is necessary to understand the nature and severity of CCD associated with mTBI for treatment planning and goal setting. Yet, the complexity of mTBI sustained in combat, which often co-occurs with PTSD and other psychological health and physiological issues, creates a clinical challenge for speech-language pathologists worldwide. The purpose of the paper is to explore methods for substantiating the nature and severity of CCD described by service members returning from combat. Methods: To better understand the nature of the functional cognitive-communication deficits described by service members returning from combat, a patient questionnaire and a test protocol were designed and administered to over 200 patients. Preliminary impressions are described addressing the nature of the deficits and the challenges faced in differentiating the etiologies of the CCD. Conclusions: Speech-language pathologists are challenged with evaluating, diagnosing, and treating the cognitive-communication deficits of mTBI resulting from combat-related injuries. Assessments that are sensitive to the functional deficits of mTBI are recommended. An interdisciplinary rehabilitation model is essential for differentially diagnosing the consequences of mTBI, PTSD, and other psychological and physical health concerns.

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