Evaluating the impact of treatment for sleep/wake disorders on recovery of cognition and communication in adults with chronic TBI.
OBJECTIVE
To longitudinally examine objective and self-reported outcomes for recovery of cognition, communication, mood and participation in adults with traumatic brain injury (TBI) and co-morbid post-traumatic sleep/wake disorders.


METHODS
Prospective, longitudinal, single blind outcome study.


METHODS
Community-based.


METHODS
Ten adults with moderate-severe TBI and two adults with mild TBI and persistent symptoms aged 18-58 years. Six males and six females, who were 1-22 years post-injury and presented with self-reported sleep/wake disturbances with onset post-injury.


METHODS
Individualized treatments for sleep/wake disorders that included sleep hygiene recommendations, pharmacological interventions and/or treatments for sleep apnea with follow-up.


METHODS
Insomnia Severity Index, Beck Depression and Anxiety Inventories, Latrobe Communication Questionnaire, Speed and Capacity of Language Processing, Test of Everyday Attention, Repeatable Battery for the Assessment of Neuropsychological Status, Daily Cognitive-Communication and Sleep Profile.


RESULTS
Group analysis revealed positive trends in change for each measure and across sub-tests of all measures. Statistically significant changes were noted in insomnia severity, p = 0.0003; depression severity, p = 0.03; language, p = 0.01; speed of language processing, p = 0.007.


CONCLUSIONS
These results add to a small but growing body of evidence that sleep/wake disorders associated with TBI exacerbate trauma-related cognitive, communication and mood impairments. Treatment for sleep/wake disorders may optimize recovery and outcomes.
Department of Rehabilitation Science, University of Toronto , Toronto, ON , Canada .
Catherine
C
Wiseman-Hakes
Brian
B
Murray
Rahim
R
Moineddin
Elizabeth
E
Rochon
Nora
N
Cullen
Judith
J
Gargaro
Angela
A
Colantonio
D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease; D003071:Cognition; D003142:Communication; D003863:Depression / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography; D011446:Prospective Studies; D020127:Recovery of Function; D057566:Self Report; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012891:Sleep Apnea Syndromes / Q000628:therapy; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome