Journal
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
Volume 35, Issue 1, Pages 145-154Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.pmr.2023.06.022
Keywords
Brain injury; Disorders of consciousness; Pain; Sleep; Coma
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This article discusses the importance of the emergence of consciousness in brain-injured patients and presents a framework for evaluating and tailoring treatment of sleep and pain. Although more research is needed, validated tools are currently available for assessing consciousness, pain, and sleep.
Despite the evolving practice of brain injury medicine, consciousness remains enigmatic. Most patients with disorders of consciousness have disordered sleep and return of normal sleep architecture is essential to the emergence of consciousness and the healing brain. In this article we lay a framework for understanding the emergence of consciousness in brain-injured patients. We then explore ways to use that framework to evaluate and tailor treatment of sleep and pain in patients with disorders of consciousness. Although more research is needed to empower better treatment in the future, validated tools now exist for evaluation of emergent consciousness, pain, and sleep.
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