801 Obstructive Sleep Apnea Symptoms Predict Cognitive Function Following Mild Traumatic Brain Injury

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A312-A312
Author(s):  
Andrew Le ◽  
Natalie Dailey ◽  
Michael Grandner ◽  
William Killgore
Keyword(s):  
Traumatic Brain Injury ◽  
Obstructive Sleep Apnea ◽  
Brain Injury ◽  
Reaction Time ◽  
Sleep Apnea ◽  
Cognitive Function ◽  
Cognitive Processing ◽  
Sleep Disturbances ◽  
Healthy Controls ◽  
Obstructive Sleep

Abstract Introduction Sleep disturbances are commonly reported following mild traumatic brain injury (mTBI). Specifically, one of these disturbances is obstructive sleep apnea (OSA), which involves repeated episodes of reduced upper-airway flow during sleep. When compared to the general population, OSA is reported at a much higher rate among the mTBI population. However, little research has investigated the relationship between OSA and cognitive performance among the mTBI population. We predicted that in those who suffered a mTBI, symptoms of sleep apnea would be predictive lower cognitive processing. Methods We collected data from 37 healthy controls (Mean age = 24.3 □ 5.8) and 145 participants with mTBI (Mean age = 24.3 □ 6.8), ranging from 2 weeks to 12 months post-injury. Participants completed the Pittsburg Sleep Quality Index (PSQI) including questions indicative of OSA, such as “cannot breathe comfortably” and “cough or snore loudly” during sleep. We calculated the PSQI Sleep Disturbance (PSQI-SD) composite score, which ranged from 0 to 2. Participants completed the Automated Neuropsychological Assessment Metrics (ANAM4), a novel computer-based assessment, to measure reaction time (RT). Results When comparing the percentage of participants in each group endorsing sleep disturbances on the PSQI-SD, we found a significant difference in the proportion of individuals scoring a 2 on PSQI-SD between the groups (□2(2) = 13.55, p = .001). In healthy controls, 8% scored 0, 89% scored 1, and 3% scored 2 on the PSQI-SD. In contrast, following mTBI, 1.4% scored 0, 72.4% scored 1, and 26.2% scored 2 on the PSQI-SD. Furthermore, PSQI-SD significantly predicted RT (□ = .18, p = .03) in the mTBI group, a relationship not observed in the control group (□ = .30, p = .07). Conclusion mTBI increases the incidence of sleep disturbances and symptoms related to OSA. Furthermore, sleep disturbances and OSA-related symptoms were predictive of cognitive performance in individuals who sustained a mTBI, but not healthy controls. Increases in PSQI-SD scores were associated with increased RT, indicating greater deficits in cognitive function, specifically reaction time. These data provide evidence that higher severity in respiratory symptoms relating to sleep apnea hinders cognitive processing, particularly for individuals who have suffered a mTBI. Support (if any):

806 Barriers to screening and diagnosis of obstructive sleep apnea during inpatient traumatic brain injury rehabilitation

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A314-A315
Author(s):  
Bridget Cotner ◽  
Risa Nakase-Richardson ◽  
Becky Gius ◽  
Lauren Fournier ◽  
Alexa Watach ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Obstructive Sleep Apnea ◽  
Brain Injury ◽  
Sleep Apnea ◽  
Inpatient Rehabilitation ◽  
Screening Tools ◽  
Diagnostic Tools ◽  
Evidence Based ◽  
Implementation Barriers ◽  
Obstructive Sleep

Abstract Introduction Obstructive Sleep Apnea (OSA) is prevalent after moderate to severe traumatic brain injury (TBI) and may diminish recovery when left untreated. Despite the demonstrated importance of treating OSA following TBI, assessment for OSA during or soon after inpatient rehabilitation for TBI is limited. Little is known about barriers to implementing OSA screening and early diagnosis during inpatient rehabilitation thus hindering the translation of evidence-based OSA assessment procedures into clinical practice and potentially delaying necessary OSA treatment. The current analysis explored facilitators and barriers to implementing OSA screening tools in an inpatient rehabilitation setting from the perspectives of end user stakeholders. Methods Patients, families, industry, clinical providers and administrators participated in a two-day meeting following completion of a diagnostic clinical trial of OSA screening and diagnostic tools during inpatient rehabilitation. Stakeholders were provided with open ended questions generated by study investigators and given the opportunity to respond on paper or a “graffiti wall” (i.e., white board). Example questions include “What are the greatest needs of the healthcare system related to sleep apnea and TBI?” and “What are the key things we need to consider to move results into real-world practice?” Qualitative content analyses using a rapid matrix approach were conducted from stakeholder feedback obtained during the two-day meeting, which included a guided review of emerging OSA research and discussion of potential implementation barriers of OSA assessment during inpatient rehabilitation. Results Improved screening and treatment practices for OSA were the greatest needs identified. To meet these needs, stakeholders identified the importance of improving patient, family, and staff understanding of OSA (e.g., health literacy) and other sleep disorders through education; inpatient rehabilitation access to resources (technology; sleep providers); and reimbursement for additional inpatient procedures. Conclusion Although treatment of OSA is crucial for recovery during inpatient rehabilitation following TBI, barriers to earlier recognition, diagnosis, and treatment of OSA exists across several different domains, including education, resources, and funding policies. Findings support future implementation efforts to translate evidence-based care into practice to improve patient outcomes. Support (if any) PCORI-NCT03033901

The Use of Nasal Trumpet in a Traumatic Brain Injury Patient With Obstructive Sleep Apnea

PM&R ◽  
2009 ◽  
Vol 1 (10) ◽  
pp. 977-979 ◽  
Author(s):  
Jaspal R. Singh ◽  
Miriam Segal ◽  
Richard Malone ◽  
Mohammed Zubair
Keyword(s):  
Traumatic Brain Injury ◽  
Obstructive Sleep Apnea ◽  
Brain Injury ◽  
Sleep Apnea ◽  
Traumatic Brain Injury Patient ◽  
Obstructive Sleep ◽  
Injury Patient

Cognitive Impairment in Patients With Traumatic Brain Injury and Obstructive Sleep Apnea

2007 ◽  
Vol 88 (10) ◽  
pp. 1284-1288 ◽  
Author(s):  
Mark C. Wilde ◽  
Richard J. Castriotta ◽  
Jenny M. Lai ◽  
Strahil Atanasov ◽  
Brent E. Masel ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Brain Injury ◽  
Sleep Apnea ◽  
Obstructive Sleep

Risk Factors of Obstructive Sleep Apnea among Individuals with Moderate to Severe Traumatic Brain Injury

2019 ◽  
Vol 100 (12) ◽  
pp. e199
Author(s):  
Kimberley Monden ◽  
Dave Mellick ◽  
Kathleen Bell ◽  
Jesse Fann ◽  
Jeanne Hoffman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Obstructive Sleep Apnea ◽  
Brain Injury ◽  
Sleep Apnea ◽  
Severe Traumatic Brain Injury ◽  
Obstructive Sleep

scholarly journals Creatine Supplementation and Brain Health

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 586 ◽  
Author(s):  
Hamilton Roschel ◽  
Bruno Gualano ◽  
Sergej M. Ostojic ◽  
Eric S. Rawson
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Function ◽  
Cognitive Processing ◽  
Brain Function ◽  
Creatine Supplementation ◽  
Short Review ◽  
Future Research ◽  
Brain Health

There is a robust and compelling body of evidence supporting the ergogenic and therapeutic role of creatine supplementation in muscle. Beyond these well-described effects and mechanisms, there is literature to suggest that creatine may also be beneficial to brain health (e.g., cognitive processing, brain function, and recovery from trauma). This is a growing field of research, and the purpose of this short review is to provide an update on the effects of creatine supplementation on brain health in humans. There is a potential for creatine supplementation to improve cognitive processing, especially in conditions characterized by brain creatine deficits, which could be induced by acute stressors (e.g., exercise, sleep deprivation) or chronic, pathologic conditions (e.g., creatine synthesis enzyme deficiencies, mild traumatic brain injury, aging, Alzheimer’s disease, depression). Despite this, the optimal creatine protocol able to increase brain creatine levels is still to be determined. Similarly, supplementation studies concomitantly assessing brain creatine and cognitive function are needed. Collectively, data available are promising and future research in the area is warranted.

Effect of Sleep Disturbances on Blood Pressure

Hypertension ◽  
2021 ◽  
Author(s):  
Nour Makarem ◽  
Carmela Alcántara ◽  
Natasha Williams ◽  
Natalie A. Bello ◽  
Marwah Abdalla
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Shift Work ◽  
Health Care Providers ◽  
Sleep Disturbances ◽  
Care Providers ◽  
Short Sleep ◽  
Hypertension Risk ◽  
Obstructive Sleep

This review summarizes recent literature addressing the association of short sleep duration, shift work, and obstructive sleep apnea with hypertension risk, blood pressure (BP) levels, and 24-hour ambulatory BP. Observational studies demonstrate that subjectively assessed short sleep increases hypertension risk, though conflicting results are observed in studies of objectively assessed short sleep. Intervention studies demonstrate that mild and severe sleep restriction are associated with higher BP. Rotating and night shift work are associated with hypertension as shift work may exacerbate the detrimental impact of short sleep on BP. Further, studies demonstrate that shift work may increase nighttime BP and reduce BP control in patients with hypertension. Finally, moderate to severe obstructive sleep apnea is associated with hypertension, particularly resistant hypertension. Obstructive sleep apnea is also associated with abnormal 24-hour ambulatory BP profiles, including higher daytime and nighttime BP, nondipping BP, and a higher morning surge. Continuous positive airway pressure treatment may lower BP and improve BP dipping. In conclusion, efforts should be made to educate patients and health care providers about the importance of identifying and treating sleep disturbances for hypertension prevention and management. Empirically supported sleep health interventions represent a critical next step to advance this research area and establish causality.

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