title: Sleep and pain complaints in symptomatic traumatic brain injury and neurologic populations.
abstract: OBJECTIVE
  To compare the incidence of sleep and pain complaints in symptomatic traumatic brain injury (TBI) (mild vs moderate/severe) and neurologic populations.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Outpatient neuropsychology service at a university-affiliated tertiary care center.
  
  
  METHODS
  A consecutive sample of mild (n = 127) and moderate to severe (n = 75) patients with TBI and a general neurologic (non-TBI) group (n = 123) referred for neuropsychological assessment.
  
  
  METHODS
  Patient report of sleep and/or pain problems.
  
  
  RESULTS
  TBI subjects had significantly more insomnia (56.4% vs 30.9%) and pain complaints (58.9% vs 22%) than non-TBI subjects (p < .0001). For both subject groups, the presence of pain increased insomnia approximately twofold. Poor sleep maintainance was the most common sleep problem. In those subjects without pain, TBI patients reported more sleep complaints that non-TBI patients (p = .05). Mild TBI patients reported significantly (p < .0001) more pain than patients with a moderate to severe injury (70% vs 40%). In TBI subjects without pain, there were significantly more insomnia complaints in mild than in moderate to severe injuries (p < .01).
  
  
  CONCLUSIONS
  TBI patients with persistent cognitive complaints have more sleep and pain concerns than general neurologic patients. Pain is strongly associated with sleep problems. Aggressive evaluation and treatment of pain and sleep problems in the TBI, especially mild TBI, population appears warranted and may contribute to increased disability. The etiology of greater sleep and pain problems in the mild than in the more severe TBI patients requires further study.
authors.affiliation: Emma Pendleton Bradley Hospital, Providence, RI, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Beetar
authors.forename: T J
authors.initials: TJ
authors.lastname: Guilmette
authors.forename: F R
authors.initials: FR
authors.lastname: Sparadeo
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000145:classification / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003710:Demography; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology*; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology*