Sleep problems may persist for up to 18 months after a traumatic brain injury, suggests a new study published in the journal Neurology.

[A woman asleep on her computer]Share on Pinterest
People with TBI were more likely to experience excessive daytime sleepiness, the new study found.

Additionally, the study suggests that many people who experience a traumatic brain injury (TBI) may not be aware that they are experiencing sleep problems.

According to the Centers for Disease Control and Prevention (CDC), every year, around 1.7 million people in the United States experience a TBI – defined as a sudden blow or jolt to the head that interferes with brain functioning.

Children aged 0-4 years, adolescents aged 15-19 years and adults aged 65 and older are most likely to experience TBI.

Symptoms of TBI include problems thinking, nausea or vomiting, headache, dizziness, fatigue, and irritability. Sleep problems may also occur following a TBI, according to the CDC, but to what extent?

This is what study author Dr. Lukas Imbach, of the University Hospital Zurich in Switzerland, and colleagues set out to investigate with their new research.

The team enrolled 73 participants. Of these, 31 had experienced a first TBI 18 months previously, while 42 were healthy individuals who had not experienced a TBI in the past 18 months.

As well as reporting their own sleep behavior and daytime sleepiness, the subjects were required to wear a body-monitoring device on their wrist for 2 weeks, allowing to the researchers to assess their sleep behavior.

Fast facts about TBI
  • Of the 1.7 million people in the U.S. each year who sustain a TBI, around 275,000 are hospitalized
  • Falls are the leading cause of TBI
  • Motor vehicle accidents are the leading cause of TBI-related death.

Learn more about TBI

Additionally, participants spent one night in a sleep monitoring lab; their brain activity, eye movements, muscle activity, and heart rhythm were assessed as they slept.

Subjects also took part in a test that assessed how fast they fell asleep during the day in a quiet environment – a measure of excessive daytime sleepiness.

Participants with TBI slept an average of 8 hours each night, compared with an average of 7 hours a night for healthy subjects.

Subjects with TBI were much more likely to experience excessive daytime sleepiness than the healthy subjects, the researchers found, at 67 percent and 19 percent, respectively.

When subjects with TBI were asked how sleepy they felt during the daytime, however, they reported feeling no more sleepy than the healthy participants, suggesting that most individuals with TBI may not be aware of their sleep problems.

According to the American Sleep Association (ASA), excessive daytime sleepiness is a leading cause of fatalities from car accidents, and it is one of the most common symptoms for people with sleep disorders.

As such, Dr. Imbach notes that individuals with TBI and their doctors should be monitoring this issue.

“The study also shows us that people with TBI may not be able to accurately assess their own sleep problems,” he adds. “Since this is how the sleep quality of many people with TBI is assessed, this may be a concern.”

There was no difference in sleep problems among participants with mild or severe TBI, according to the researchers, and they did not identify any other problems that may explain sleep problems for those with TBI.

Based on their results, the researchers suggest that individuals who experience TBI may have sleep problems for up to 18 months after injury, although they are unlikely to be aware of it.

The results could have clinical implications for people with TBI.

This study makes a compelling case that sleep-wake disorders after TBI may represent a silent epidemic.

It raises the question as to whether people with TBI should be referred for sleep studies. But further study is needed before any new recommendations are made or any guidelines are changed.”

Dr. Lukas Imbach

Learn more about a drug that could reduce damage from TBI.