title: Sleep difficulties one year following mild traumatic brain injury in a population-based study.
abstract: BACKGROUND
  Sleep quality affects all aspects of daily functioning, and it is vital for facilitating recovery from illness and injury. Sleep commonly becomes disrupted following moderate to severe brain injury, yet little is known about the prevalence of sleep disruption over time and how it impacts on recovery following mild injury.
  
  
  METHODS
  This was a longitudinal study of 346 adults who experienced a mild brain injury (aged ≥16 years) identified within a population-based incidence sample in New Zealand. The prevalence of sleep difficulties was assessed at baseline (within two weeks), one, six and 12 months, alongside other key outcomes.
  
  
  RESULTS
  One year post injury, 41.4% of people were identified as having clinically significant sleep difficulties, with 21.0% at a level indicative of insomnia. Poor sleep quality at baseline was significantly predictive of poorer post-concussion symptoms, mood, community integration, and cognitive ability one year post injury. The prevalence of insomnia following mild traumatic brain injury (TBI) was more than three times the rate found in the general population. Of those completing a sleep assessment at six and 12 months, 44.9% of the sample showed improvements in sleep quality, 16.2% remained stable, and 38.9% worsened.
  
  
  CONCLUSIONS
  Screening for sleep difficulties should occur routinely following a mild brain injury to identify adults potentially at risk of poor recovery. Interventions to improve sleep are needed to facilitate recovery from injury, and to prevent persistent sleep difficulties emerging.
authors.affiliation: National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand. Electronic address: alice.theadom@aut.ac.nz.
authors.forename: Alice
authors.initials: A
authors.lastname: Theadom
authors.affiliation: School of Psychology, University of Surrey, Guildford, Surrey, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Cropley
authors.affiliation: National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Priya
authors.initials: P
authors.lastname: Parmar
authors.affiliation: School of Psychology, University of Auckland, Auckland, New Zealand.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Barker-Collo
authors.affiliation: School of Psychology, University of Waikato, Hamilton, New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Starkey
authors.affiliation: National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Kelly
authors.initials: K
authors.lastname: Jones
authors.affiliation: National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Valery L
authors.initials: VL
authors.lastname: Feigin
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Adult; Epidemiology; Mild traumatic brain injury; Recovery; Sleep