title: Evaluation of Sleep Disorders in Patients With Severe Traumatic Brain Injury During Rehabilitation.
abstract: OBJECTIVE
  To explore the presence and types of sleep disorders in chronic patients with severe traumatic brain injury (TBI) undergoing inpatient rehabilitation using formal diagnostic criteria based on the International Classification of Sleep Disorders, 2nd edition.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Inpatient brain injury rehabilitation units.
  
  
  METHODS
  Chronic inpatients with severe TBI (N=30) were evaluated during rehabilitation.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participants wore an actiwatch for 7 days and completed self-report measures on sleep, mood, fatigue, pain, and daytime sleepiness.
  
  
  RESULTS
  Twenty participants (67%) had a sleep-wake cycle disturbance, of which 15 (50%) met diagnostic criteria for a sleep disorder. Diagnosed sleep disorders in the sample were insomnia (26.7%), posttraumatic hypersomnia (6.7%), delayed sleep phase syndrome (10%), irregular sleep-wake pattern disorder (3.3%), and periodic limb movement disorder (3.3%). Sleep quality was estimated by senior clinical staff as interfering with rehabilitation in 36.6% of the sample. Poor sleep quality was associated with greater anxiety, fatigue, and daytime sleepiness.
  
  
  CONCLUSIONS
  Consistent with previous studies, the present study showed high levels of sleep-wake cycle disturbances in patients with severe TBI undergoing rehabilitation, which were associated with anxiety, fatigue, and daytime sleepiness. These findings highlight the importance of assessing and treating sleep problems in patients with TBI undergoing rehabilitation.
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom. Electronic address: maria.gardani@glasgow.ac.uk.
authors.forename: Maria
authors.initials: M
authors.lastname: Gardani
authors.affiliation: National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom.
authors.forename: Eleni
authors.initials: E
authors.lastname: Morfiri
authors.affiliation: National Health Service Fife, Fife, United Kingdom.
authors.forename: Allan
authors.initials: A
authors.lastname: Thomson
authors.affiliation: Brain Injury Rehabilitation Trust, Glasgow, United Kingdom; Department of Psychology, University of Stirling, Stirling, United Kingdom.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Neill
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: McMillan
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D001930:Brain Injuries / Q000453:epidemiology* / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012047:Rehabilitation Centers; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D015599:Trauma Severity Indices
keywords: Brain injuries; Circadian rhythm; Rehabilitation; Sleep; Sleep disorders; Sleep initiation and maintenance disorders