Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: A meta-analysis

Background: Sleep is often disrupted following a traumatic brain injury (TBI), which may compromise recovery and quality of life. Prevalence rates vary widely, reflecting differences in the criteria and measures that are used to assess sleep, as well as sample differences. This meta-analysis examined the prevalence of general and specific, and formally and informally diagnosed, sleep disturbances following TBI in order to establish the nature and extent of these sequelae and their potential impact on recovery. Methods: Data from 21 studies, which assessed (1) sleep disturbances, regardless of type or severity, (2) diagnosed sleep disorders, and (3) specific sleep problems following TBI, were analyzed and compared to data for the general population. Results: Overall, 50% of people suffered from some form of sleep disturbance after a TBI and 25-29% had a diagnosed sleep disorder (insomnia, hypersomnia, apnea) - rates that are much higher than those seen in the general population. They were also two to four times more likely to experience problems with sleep maintenance and efficiency, nightmares, excessive sleepiness, early awakenings, and sleep walking. Conclusion: Sleep disturbances are very common after TBI and have the potential to seriously undermine patient rehabilitation, recovery, and outcomes; making it important to routinely screen for such problems in order to assess both treatment needs and their potential impact on recovery and outcome. Crown Copyright (C) 2012 Published by Elsevier B.V. All rights reserved.