Sleep-wake disorders persist 18 months after traumatic brain injury but remain underrecognized

Imbach, Lukas L; Büchele, Fabian; Valko, Philipp O; Li, Tongzhou; Maric, Angelina; Stover, John F; Bassetti, Claudio; Mica, Ladislav; Werth, Esther; Baumann, Christian R (2016). Sleep-wake disorders persist 18 months after traumatic brain injury but remain underrecognized. Neurology, 86(21), pp. 1945-1949. Lippincott Williams & Wilkins 10.1212/WNL.0000000000002697

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OBJECTIVE This study is a prospective, controlled clinical and electrophysiologic trial examining the chronic course of posttraumatic sleep-wake disturbances (SWD). METHODS We screened 140 patients with acute, first-ever traumatic brain injury of any severity and included 60 patients for prospective follow-up examinations. Patients with prior brain trauma, other neurologic or systemic disease, drug abuse, or psychiatric comorbidities were excluded. Eighteen months after trauma, we performed detailed sleep assessment in 31 participants. As a control group, we enrolled healthy individuals without prior brain trauma matched for age, sex, and sleep satiation. RESULTS In the chronic state after traumatic brain injury, sleep need per 24 hours was persistently increased in trauma patients (8.1 ± 0.5 hours) as compared to healthy controls (7.1 ± 0.7 hours). The prevalence of chronic objective excessive daytime sleepiness was 67% in patients with brain trauma compared to 19% in controls. Patients significantly underestimated excessive daytime sleepiness and sleep need, emphasizing the unreliability of self-assessments on SWD in trauma patients. CONCLUSIONS This study provides prospective, controlled, and objective evidence for chronic persistence of posttraumatic SWD, which remain underestimated by patients. These results have clinical and medicolegal implications given that SWD can exacerbate other outcomes of traumatic brain injury, impair quality of life, and are associated with public safety hazards.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Bassetti, Claudio


600 Technology > 610 Medicine & health




Lippincott Williams & Wilkins




Stefanie Hetzenecker

Date Deposited:

28 Jul 2016 12:05

Last Modified:

28 Jul 2016 12:05

Publisher DOI:


PubMed ID:





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