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Functional improvement after severe brain injury with disorder of consciousness paralleling treatment for comorbid obstructive sleep apnoea

a case report

Silva, Marc A.a,b,c,e; Schwartz, Daniel J.d,f; Nakase-Richardson, Risaa,d,e

International Journal of Rehabilitation Research: September 2019 - Volume 42 - Issue 3 - p 285–288
doi: 10.1097/MRR.0000000000000364
Case Report

Survivors of brain injury who have disorders of consciousness often have chronic functional deficits and disability. Obstructive sleep apnoea, a sleep-related breathing disorder, is a medical comorbid condition common among persons with brain injury and is injurious to health. Research on obstructive sleep apnoea treatment among brain-injured patients–particularly persons with disorders of consciousness–is sparse. This case study describes a patient with severe brain injury admitted for neurorehabilitation in a minimally conscious state. Obstructive sleep apnoea was identified and treated. Treatment compliance was variable, and functional motor and cognitive improvement were observed during periods of better compliance. Study design does not permit casual attribution for functional improvement, but identification and treatment of obstructive sleep apnoea are suggested as a possible way to promote recovery after brain injury.

aMental Health & Behavioral Sciences Service, James A. Haley Veterans’ Hospital

Departments of bPsychiatry & Behavioral Neurosciences


dInternal Medicine, University of South Florida

eDefense & Veterans Brain Injury Center

fMedical Service, James A. Haley Veterans’ Hospital, Tampa, Florida, USA

Received 17 May 2019 Accepted 20 June 2019

Portions of this work were presented at the 92nd annual meeting of American Congress of Rehabilitation Medicine, Dallas, Texas. No work resembling the enclosed article has been published or is being submitted for publication elsewhere.

Correspondence to Marc A. Silva, PhD, James A. Haley Veterans Hospital, 13000 Bruce B. Downs Blvd. (116-B), Tampa, FL 33612, USA, Tel: +1 813 972 2000; fax: +1 813 631 3057; e-mail:

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