Treating sleep disorders following traumatic brain injury in adults: Time for renewed effort?

Kelsea Stewart; Nicholas Shakarishvili; Adriana Michalak; Emily L Maschauer; Natalie Jenkins; Renata L Riha

doi:10.1016/j.smrv.2022.101631

Treating sleep disorders following traumatic brain injury in adults: Time for renewed effort?

Sleep Med Rev. 2022 Jun:63:101631. doi: 10.1016/j.smrv.2022.101631. Epub 2022 Apr 14.

Authors

Kelsea Stewart¹, Nicholas Shakarishvili¹, Adriana Michalak¹, Emily L Maschauer¹, Natalie Jenkins², Renata L Riha³

Affiliations

¹ Sleep Research Unit, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, USA.
² EPAD, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, USA.
³ Sleep Research Unit, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, USA; Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, Scotland, USA. Electronic address: rriha1@exseed.ed.ac.uk.

PMID: 35623210
DOI: 10.1016/j.smrv.2022.101631

Abstract

Traumatic brain injury (TBI) disrupts normal brain function and can lead to chronic symptoms of sleep disturbance, pain, irritability, and depression. Sleep disorders occur in 30-70% of individuals who have experienced TBI. Disturbed sleep impairs the recovery process and may exacerbate other issues that arise because of brain injury (e.g., headaches, depression). Noticeable benefits have been reported when sleep problems due to TBI are addressed and treated; for instance, treating post-TBI insomnia reduces the expression of inflammatory genes, potentially reducing ongoing neurological damage. In this review, we discuss twenty-four randomised clinical trials (RCT) published to date (August 2021), exploring interventions for sleep disturbances resulting from TBI. Treatment effects were observed for insomnia, circadian rhythm disorders, hypersomnia, and general sleep disturbance. However, the evidence remains limited and significant methodological issues are discussed with a recommendation for further research.

Keywords: Randomised clinical trials; Review; Sleep; Sleep disorders; TBI; Traumatic brain injury; Treatment.

Publication types

Review

MeSH terms

Adult
Brain Injuries, Traumatic* / complications
Disorders of Excessive Somnolence* / etiology
Humans
Sleep
Sleep Initiation and Maintenance Disorders* / complications
Sleep Initiation and Maintenance Disorders* / therapy
Sleep Wake Disorders* / diagnosis
Sleep Wake Disorders* / etiology
Sleep Wake Disorders* / therapy