Insomnia symptoms and behavioural health symptoms in veterans 1 year after traumatic brain injury.
OBJECTIVE
Insomnia and behavioural health symptoms 1 year after traumatic brain injury (TBI) were examined in a clinical sample representative of veterans who received inpatient treatment for TBI-related issues within the Veterans Health Administration.


METHODS
This was a cross-sectional sub-study (n = 112) of the Polytrauma Rehabilitation Centres' traumatic brain injury model system programme. Prevalence estimates of insomnia, depression, general anxiety, nightmares, headache and substance use, stratified by injury severity, were derived. Univariate logistic regression was used to examine unadjusted effects for each behavioural health problem and insomnia by injury severity.


RESULTS
Participants were primarily male, < 30 years old and high school educated. Twenty-nine per cent met study criteria for insomnia; those with mild TBI were significantly more likely to meet criteria (43%) than those with moderate/severe TBI (22%), χ(2)(1, n = 112) = 5.088, p ≤ 0.05. Univariable logistic regression analyses revealed depressive symptoms and general anxiety were significantly associated with insomnia symptoms after TBI of any severity. Headache and binge drinking were significantly inversely related to insomnia symptoms after moderate/severe TBI, but not MTBI.


CONCLUSIONS
Veterans with history of TBI, of any severity, and current insomnia symptoms may be at increased risk for depression and anxiety 1 year after TBI.
a Hunter Holmes McGuire Veterans Affairs Medical Center , Richmond , VA , USA .|b Virginia Commonwealth University , Richmond , VA , USA .
Leah
L
Farrell-Carnahan
c James A. Haley Veterans Hospital , Tampa , FL , USA .
Scott
S
Barnett
d Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA .|e University of Minnesota Medical School , Minneapolis , MN , USA .
Gregory
G
Lamberty
f Indiana University School of Medicine , Indianapolis , IN , USA .
Flora M
FM
Hammond
c James A. Haley Veterans Hospital , Tampa , FL , USA .
Tracy S
TS
Kretzmer
a Hunter Holmes McGuire Veterans Affairs Medical Center , Richmond , VA , USA .|b Virginia Commonwealth University , Richmond , VA , USA .|g Defense and Veterans Brain Injury Center , Richmond , VA , USA , and.
Laura M
LM
Franke
a Hunter Holmes McGuire Veterans Affairs Medical Center , Richmond , VA , USA .
Meghan
M
Geiss
h VA Palo Alto Health Care System , Palo Alto , CA , USA.
Laura
L
Howe
c James A. Haley Veterans Hospital , Tampa , FL , USA .
Risa
R
Nakase-Richardson
D000328:Adult; D001007:Anxiety; D001519:Behavior; D063425:Binge Drinking; D001930:Brain Injuries / Q000209:etiology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D006261:Headache; D006262:Health; D006801:Humans; D008297:Male; D015995:Prevalence; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology; D055815:Young Adult
Anxiety; TBI; depression; headache; insomnia; substance use; traumatic brain injury