title: Variability of respiration and sleep during polysomnography in individuals with TBI.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is commonly found in individuals with traumatic brain injury (TBI) and may exacerbate TBI-related symptoms. Nocturnal polysomnography (NPSG) is considered the gold standard for detecting the presence of sleep apnea. However, there is a limitation with its use known as the "first-night effect" (aberrant polysomnography findings on the first night in a sleep lab).
  
  
  OBJECTIVE
  The primary objectives were to investigate the night-to-night consistency of diagnosing and classifying obstructive sleep apnea in individuals with TBI, and ascertain if individuals with TBI are prone to a first-night effect.
  
  
  METHODS
  47 community-dwelling adults with self-reported mild-to-severe TBI underwent two nights of in-laboratory NPSG to examine variability between the first and second night with regards to OSA diagnosis and severity as well as sleep architecture.
  
  
  RESULTS
  OSA detection and severity were consistent from night-to-night in 89% of participants with TBI. Participants with TBI demonstrated longer REM latency on the first night compared to the second night of sleep study.
  
  
  CONCLUSIONS
  These findings indicate that two nights of in-laboratory NPSG are generally consistent in reliably diagnosing OSA in individuals with TBI and that first-night effects are minimal. One night of NPSG has diagnostic utility in the evaluation of sleep disorders in individuals with TBI.
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: William
authors.initials: W
authors.lastname: Lu
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Cantor
authors.affiliation: Department of Medicine, John Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: R Nisha
authors.initials: RN
authors.lastname: Aurora
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Nguyen
authors.affiliation: The Shepherd Center, Atlanta, GA, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Ashman
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Spielman
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Ambrose
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Krellman
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000145:classification / Q000175:diagnosis* / Q000209:etiology*; D012895:Sleep, REM
keywords: Traumatic brain injury; obstructive sleep apnea; polysomnography; sleep