@article{ref1,
title="Sleep disturbances in traumatic brain injury: a meta-analysis",
journal="Journal of clinical sleep medicine",
year="2015",
author="Grima, Natalie and Ponsford, Jennie and Rajaratnam, Shantha and Mansfield, Darren and Pase, Matthew P.",
volume="12",
number="3",
pages="419-428",
abstract="STUDY OBJECTIVES: Sleep disturbances are frequently reported following traumatic brain injury (TBI); however, the exact disturbances remain unclear. This meta-analysis aimed to characterize sleep disturbance in community dwelling patients with TBI as compared to controls. <br><br>METHODS: Two investigators independently conducted a systematic search of multiple electronic databases from inception to May 27, 2015. Studies were selected if they compared sleep in community dwelling individuals with TBI relative to a control population without head injury. Data were pooled in meta-analysis with outcomes expressed as the standard mean difference (SMD) and 95% confidence interval (CI). The primary outcomes were derived from polysomnography and secondary outcomes were derived from subjective sleep measures. <br><br>RESULTS: Sixteen studies were included, combining 637 TBI patients and 567 controls, all of whom were community dwelling. Pooled polysomnography data revealed that TBI patients had poorer sleep efficiency (SMD = -0.47, CI: -0.89, -0.06), shorter total sleep duration (SMD = -0.37, CI: -0.59, -0.16), and greater wake after sleep onset time (SMD = 0.60, CI: 0.33, 0.87). Although sleep architecture was similar between the groups, a trend suggested that TBI patients may spend less time in REM sleep (SMD = -0.22, CI: -0.45, 0.01). Consistent with polysomnographic derangement, TBI patients reported greater subjective sleepiness and poorer perceived sleep quality. <br><br>CONCLUSIONS: The evidence suggests that TBI is associated with widespread objective and subjective sleep deficits. The present results highlight the need for physicians to monitor and address sleep deficits following TBI.<p /> <p>Language: en</p>",
language="en",
issn="1550-9389",
doi="",
url="http://dx.doi.org/"
}