Trajectories of Sleep and Its Predictors in the First Year Following Traumatic Brain Injury

To examine how sleep patterns change over the first year following traumatic brain injury (TBI) and to determine whether specific demographic and disease characteristics predict the trajectories of sleep. Design: Prospective study. Participants: Fifty-three patients with first-ever mild to severe TBI. Main Measurements: Sleep measured by actigraphy for 7 consecutive days in the first, third, sixth, and twelfth months following TBI: Chinese versions of Beck Anxiety Inventory and Beck Depression Inventory-II (CBDI-II) measured at the same time points. Data were analyzed with a linear mixed model. Results: Sleep efficiency (the ratio of sleep time to the total time spent in bed) showed a significant upward trend during the study period. Scores on the Chinese version of the Beck Anxiety Inventory and the CBDI-II as well as the use of analgesics significantly predicted the slope of change in sleep efficiency over time. Conclusions: Poor sleep efficiency is a common symptom in the first year among patients with first-ever TBI. Healthcare providers should consider both mental health and pain issues when dealing with sleep complaints in patients with TBI.