Citation

Holcomb EM, Towns S, Kamper JE, Barnett SD, Sherer M, Evans C, Nakase-Richardson R. J. Head Trauma Rehabil. 2015; 31(2): 108-116.

Affiliation

TIRR Memorial Hermann, Houston, Texas (Drs Holcomb and Sherer); Mental Health and Behavioral Sciences (MHBS) (Drs Kamper and Nakase-Richardson), Center of Innovation in Disability Rehabilitation and Research (CINDRR) (Drs Barnett and Nakase-Richardson), and Defense and Veterans Brain Injury Center (DVBIC) (Dr Nakase-Richardson), James A. Haley Veterans' Hospital, Tampa, Florida; Department of Medicine, University of South Florida, Tampa (Dr Nakase-Richardson); Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (Dr Towns) and Methodist Rehabilitation Center, Jackson, Mississippi (Dr Evans).

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000206

PMID

26709584

Abstract

OBJECTIVE: Following traumatic brain injury, both sleep dysfunction and cognitive impairment are common. Unfortunately, little is known regarding the potential associations between these 2 symptoms during acute recovery. This study sought to prospectively examine the relationship between ratings of sleep dysfunction and serial cognitive assessments among traumatic brain injury acute neurorehabilitation admissions.

METHODS: Participants were consecutive admissions to a free-standing rehabilitation hospital following moderate to severe traumatic brain injury (Median Emergency Department Glasgow Coma Scale = 7). Participants were assessed for sleep-wake cycle disturbance (SWCD) and cognitive functioning at admission and with subsequent weekly examinations. Participants were grouped on the basis of presence (SWCD+) or absence (SWCD-) of sleep dysfunction for each examination; groups were equivalent on demographic and injury variables. Individual Growth Curve modeling was used to examine course of Cognitive Test for Delirium performance across examinations.

RESULTS: Individual Growth Curve modeling revealed a significant interaction between examination number (ie, time) and SWCD group (β = -4.03, P <.001) on total Cognitive Test for Delirium score. The SWCD+ ratings on later examinations were predicted to result in lower Cognitive Test for Delirium scores and greater cognitive impairment over time.

CONCLUSIONS: This study has implications for improving neurorehabilitation treatment, as targeting sleep dysfunction for early intervention may facilitate cognitive recovery.

Language: en