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Trajectories of Sleep and Its Predictors in the First Year Following Traumatic Brain Injury

Chen, Pin-Yuan MD, PhD; Tsai, Pei-Shan PhD, RN; Chen, Ning-Hung MD; Chaung, Li-Pang MD; Lee, Cheng-Chi MD; Chen, Ching-Chang MD; Chiu, Hsiao-Ting BS; Lu, Yu-Jen MD; Wei, Kuo-Chen MD; Chiu, Hsiao-Yean PhD, RN

Journal of Head Trauma Rehabilitation: July/August 2015 - Volume 30 - Issue 4 - p E50–E55
doi: 10.1097/HTR.0000000000000086
Original Articles

Objectives: To examine how sleep patterns change over the first year following traumatic brain injury (TBI) and to determine whether specific demographic and disease characteristics predict the trajectories of sleep.

Design: Prospective study.

Participants: Fifty-three patients with first-ever mild to severe TBI.

Main Measurements: Sleep measured by actigraphy for 7 consecutive days in the first, third, sixth, and twelfth months following TBI: Chinese versions of Beck Anxiety Inventory and Beck Depression Inventory-II (CBDI-II) measured at the same time points. Data were analyzed with a linear mixed model.

Results: Sleep efficiency (the ratio of sleep time to the total time spent in bed) showed a significant upward trend during the study period. Scores on the Chinese version of the Beck Anxiety Inventory and the CBDI-II as well as the use of analgesics significantly predicted the slope of change in sleep efficiency over time.

Conclusions: Poor sleep efficiency is a common symptom in the first year among patients with first-ever TBI. Healthcare providers should consider both mental health and pain issues when dealing with sleep complaints in patients with TBI.

Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan (Drs Tsai and Chiu); Sleep Center, Department of Pulmonary and Critical Care Medicine (Drs Chen and Chaung) and Department of Neurosurgery (Drs Lee, Chen, Lu, Wei, and Chen), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Physical Medicine and Rehabilitation, Sinwu Branch, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan (Dr Chiu).

Corresponding Author: Hsiao-Yean Chiu, PhD, RN, Graduate Institute of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing St, Taipei, 110 Taiwan (happyone680315@hotmail.com).

This research was supported by a grant (NSC 99-2314-B-182A-047-MY2) from the Ministry of Science and Technology, Taiwan.

The authors declare no conflicts of interest.

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