Citation

Sandsmark DK, Elliott JE, Lim MM. Sleep 2017; 40(5): zsx044.

Affiliation

Department of Medicine, Division of Pulmonary and Critical Care Medicine; Department of Behavioral Neuroscience; Oregon Institute of Occupational Health Sciences; Oregon Health & Science University, Portland, OR, USA.

Copyright

(Copyright © 2017, American Academy of Sleep Medicine, Publisher Associated Professional Sleep Societies)

DOI

10.1093/sleep/zsx044

PMID

28329120

Abstract

Sleep-wake disturbances following traumatic brain injury (TBI) are increasingly recognized as a serious consequence following injury and as a barrier to recovery. Injury-induced sleep-wake disturbances can persist for years, often impairing quality of life. Recently, there has been a nearly exponential increase in the number of primary research articles published on the pathophysiology and mechanisms underlying sleep-wake disturbances after TBI, both in animal models and human subjects, including in the pediatric population. In this review, we summarize over two hundred articles on the topic, most of which were identified objectively using reproducible online search terms in PubMed. Although these studies differ in terms of methodology and detailed outcomes, overall, recent research describes a common phenotype of excessive daytime sleepiness, nighttime sleep fragmentation, insomnia, and EEG spectral changes after TBI. Given the heterogeneity of the human disease phenotype, rigorous translation of animal models to the human condition is critical to our understanding of the mechanisms and of the temporal course of sleep-wake disturbances after injury. Arguably, this is most effectively accomplished when animal and human studies are performed by the same or collaborating research programs. Given the number of symptoms associated with TBI that are intimately related to, or directly stem from sleep dysfunction, sleep-wake disorders represent an important area in which mechanistic-based therapies may substantially impact recovery after TBI.

Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Language: en

Keywords

BCAA; EEG; TBI; animal models; glutamate; orexin; pediatric; sleep