Traumatic brain injury and sleep disturbance: A review of current research

OBJECTIVE: To summarize the current literature regarding the significant prevalence and potential consequences of sleep disturbance following traumatic brain injury (TBI), particularly mild TBI. DESIGN: PubMed and Ovid/MEDLINE databases were searched by using key words "sleep disturbance," "insomnia," "TBI," "brain injury," and "circadian rhythms." Additional sources (eg, abstracts from the annual Associated Professional Sleep Societies meeting) were also reviewed. RESULTS: Sequelae of TBI include both medical and psychiatric symptoms and frequent complaints of sleep disturbance. Sleep disturbance likely result from and contribute to multiple factors associated with the injury, all of which complicate recovery and resolution of symptoms. Interestingly, research now seems to indicate that mild TBI may be more correlated with increased likelihood of sleep disturbance than are severe forms of TBI. CONCLUSIONS: Sleep disturbance is a common consequence of TBI, but much more research is required to elucidate the nature and extent of this relation. Research needs to focus on (1) uncovering the specific types, causes, and severity of TBI that most often lead to sleep problems; (2) the specific consequences of sleep disturbance in this population (eg, impaired physical or cognitive recovery); and (3) the most effective strategies for the treatment of sleep-wake abnormalities in this population.