title: Does acute TBI-related sleep disturbance predict subsequent neuropsychiatric disturbances?
abstract: OBJECTIVE
  To determine whether sleep disturbance in the acute post-traumatic brain injury (TBI) period predicts symptoms of depression, anxiety or apathy measured 6 and 12 months after TBI.
  
  
  METHODS
  Longitudinal, observational study.
  
  
  METHODS
  First time closed-head injury patients (n = 101) were recruited and evaluated within 3 months of injury and followed longitudinally, with psychiatric evaluations at 6 and 12 months post-injury. Pre- and post-injury sleep disturbances were measured via the Medical Outcome Scale (MOS) for Sleep. Subjects were also assessed for anxiety, depression, apathy, medical comorbidity and severity of TBI.
  
  
  RESULTS
  Sleep disturbance in the acute TBI period was associated with increased symptoms of depression, anxiety and apathy 12 months post-injury.
  
  
  CONCLUSIONS
  Sleep disturbances experienced soon after trauma (i.e. <3 months after injury) predicted neuropsychiatric symptoms 1 year after injury, raising two important clinical questions: (1) Is sleep disturbance soon after trauma a prognostic marker of subsequent neuropsychiatric symptoms? and (2) Can early treatment of sleep disturbance during the post-TBI period reduce subsequent development of neuropsychiatric symptoms? Future studies with larger sample sizes and appropriate control groups could help to answer these questions, using evidence-based methods for evaluating and treating sleep disturbances.
authors: Division of Geriatric Psychiatry & Neuropsychiatry and.
authors: Vani
authors: V
authors: Rao
authors: Una
authors: U
authors: McCann
authors: Dingfen
authors: D
authors: Han
authors: Alyssa
authors: A
authors: Bergey
authors: Michael T
authors: MT
authors: Smith
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D057565:Apathy; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D023261:Glasgow Outcome Scale; D016489:Head Injuries, Closed / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology*; D009483:Neuropsychological Tests; D015995:Prevalence; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D013997:Time Factors