Self-report instruments for assessing sleep dysfunction in an adult traumatic brain injury population: a systematic review

Abstract

Objectives: To review the number and characteristics of self-reported sleep measures used to evaluate impaired sleep/wakefulness in traumatic brain injury (TBI) populations.

Methods: We conducted a comprehensive peer-reviewed literature search of Medline, Embase, PsycINFO, CINAHL, and various bibliographies. Only standardized self-report measures for evaluating sleep dysfunction and its signs were taken into consideration.

Results: Sixteen self-report measures used in TBI research and clinical practices were identified. Five were generic, five symptom-related, and six were condition-specific measures. The Pittsburgh sleep quality index and Epworth sleepiness scale were partially validated in post-acute TBI.

Conclusion: Although no instrument has been specifically developed for TBI patients, there are scientific benefits to using the existing measures. However, additional research is needed to examine their applicability to the TBI population. The design and introduction of a new instrument able to triage sleep-related complaints between depressive, other medical, and primary sleep disorders-with a section for caregiver reports-might assist in the identification of the etiology of sleep dysfunction in persons with TBI. In choosing or developing a sleep measure, researchers and clinicians must consider the specific domains they want to screen, diagnose, or monitor. Polysomnography is recommended for diagnosing specific sleep disorders that cannot be diagnosed solely using a self-report measure.

Keywords: Fatigue; Insomnia; Questionnaire; Self-report measure; Sleep; Sleepiness; Systematic review; Traumatic brain injury.