Caregiver sleep impairment and service member and veteran adjustment following traumatic brain injury is related to caregiver health-related quality of life

Tracey A Brickell; Megan M Wright; Jamie K Sullivan; Nicole V Varbedian; Kathryn A Nose; Lauren M Rather; Nicole K Tien; Louis M French; Rael T Lange

doi:10.5664/jcsm.10164

Caregiver sleep impairment and service member and veteran adjustment following traumatic brain injury is related to caregiver health-related quality of life

J Clin Sleep Med. 2022 Nov 1;18(11):2577-2588. doi: 10.5664/jcsm.10164.

Authors

Tracey A Brickell^{1

2

3

4}, Megan M Wright^{1

2

4}, Jamie K Sullivan^{1

2

4}, Nicole V Varbedian^{1

2

4}, Kathryn A Nose^{1

2

4}, Lauren M Rather^{1

2

4}, Nicole K Tien^{1

2

4}, Louis M French^{1

2

3}, Rael T Lange^{1

2

4

5}

Affiliations

¹ Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland.
² National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland.
³ Uniformed Services University of the Health Sciences, Bethesda, Maryland.
⁴ Contractor, General Dynamics Information Technology, Silver Spring, Maryland.
⁵ University of British Columbia, Vancouver, British Columbia, Canada.

Abstract

Study objectives: To examine the relationship between caregiver sleep impairment and/or service member/veteran (SMV) adjustment post-traumatic brain injury, with caregiver health-related quality of life (HRQOL).

Methods: Caregivers (n = 283) completed 18 measures of HRQOL, sleep impairment, and SMV adjustment. Caregivers were classified into 4 sleep impairment/SMV adjustment groups: 1) Good Sleep/Good Adjustment (n = 43), 2) Good Sleep/Poor Adjustment (n = 39), 3) Poor Sleep/Good Adjustment (n = 55), and 4) Poor Sleep/Poor Adjustment (n = 146).

Results: The Poor Sleep/Poor Adjustment group reported significantly worse scores on most HRQOL measures and a higher prevalence of clinically elevated T-scores (≥ 60T) on the majority of comparisons compared to the other 3 groups. The Good Sleep/Poor Adjustment and Poor Sleep/Good Adjustment groups reported worse scores on the majority of the HRQOL measures and a higher prevalence of clinically elevated scores on 7 comparisons compared to the Good Sleep/Good Adjustment group. Fewer differences were found between the Good Sleep/Poor Adjustment and Poor Sleep/Good Adjustment groups. The Poor Sleep/Poor Adjustment group reported a higher prevalence of severe ratings for SMV Irritability, Anger, and Aggression compared to the Good Sleep/Poor Adjustment group.

Conclusions: While the presence of either caregiver sleep impairment or poor SMV adjustment singularly was associated with worse caregiver HRQOL, the presence of both sleep impairment and poor SMV adjustment was associated with further impairment in HRQOL. Caregivers could benefit from sleep intervention. Treatment of SMVs neurobehavioral problems may improve the SMV's recovery and lessen sleep problems, distress, and burden among their caregivers.

Citation: Brickell TA, Wright MM, Sullivan JK, et al. Caregiver sleep impairment and service member and veteran adjustment following traumatic brain injury is related to caregiver health-related quality of life. J Clin Sleep Med. 2022;18(11):2577-2588.

Keywords: military caregiver; service member veteran adjustment; sleep impairment; traumatic brain injury.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Brain Injuries, Traumatic* / complications
Caregivers
Humans
Military Personnel*
Quality of Life
Sleep
Veterans*