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For Concussions and TBIs, Sleep Problems Can Linger For 18 Months

It’s no surprise that the effects of a concussion can linger for a while in the wake of a traumatic brain injury, but new research in the New England Journal of Medicine shines a light on just how long symptoms can persist.

The study involved 31 patients who had suffered a serious head injury within the past 18 months. Researchers asked participants to track their sleeping habits and how well-rested they felt throughout the day. Participants also spent some of their nights in a sleep lab where their brain activity, muscle and eye movements and heart function were studied and logged in real-time. Researchers also conducted daytime examinations to test for drowsiness or sleepiness, and concussion-sufferers were asked if they had any preexisting conditions unrelated to their head injury that could affect their sleep patterns. The results were compared to similar data pulled from 42 individuals who had not suffered a TBI within the last 18 months.

Concussion Symptom Study Results

After looking at the data, researchers uncovered:

  • 67 percent of individuals in the TBI group had issues with daytime sleepiness, compared to 19 percent in the control group.
  • Individuals in the TBI group did not report feeling any sleepier during the day than participants in the control group, suggesting they were unaware their injury may have resulted in chronic sleep problems.
  • People in the TBI group slept for a longer duration than those without injuries.
  • Sleep issues and daytime fatigue lingered for up to 18 months after the original head injury.

On average, 1.5 years after their brain injury, participants in the TBI group slept 8.1 hours per night vs. 7.1 hours for members in the healthy control group. Even with that extra hour of sleep, those in the TBI group were more tired during their wakeful hours, as measured by how quickly they fell asleep.

“Our data suggest that post-traumatic sleep-wake disturbances transform into a chronic state of disease in a majority of patients with TBI,” the authors of the current study wrote. “For clinicians who typically rely on these patients’ subjective symptom reporting when deciding whether to order sleep studies, this observation raises fundamental questions about the standard diagnostic evaluation of patients with TBI.”

Dr. Brian Edlow, a neurologist at Massachusetts General Hospital, wrote an accompanying editorial on the study. Dr. Edlow noted that “excessive daytime sleepiness can decrease people’s productivity at work or at school,” and it can also make them a hazard on the roadways.

So the next time you or a loved one suffers a head injury or concussion, make sure they are examined by a neurologist. These specialists can walk you through symptom progression and treatment options to give you the best chance to work through any lingering issues. For more information, contact a neurosurgeon in your area.

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David Chang, MD-PhD, DABNS, Roseville, MN
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