Spotlight on Posttraumatic sleep disturbance

In this clinical summary, Dr. Mari Viola-Saltzman discusses posttraumatic sleep disturbance, which affects 30% to 70% of individuals after traumatic brain injury and often occurs after mild head injury. Insomnia, fatigue, and sleepiness are the most frequent complaints after head injury. Narcolepsy (with or without cataplexy), sleep apnea (obstructive and/or central), periodic limb movement disorder, and parasomnias are less commonly reported after traumatic brain injury. In addition, depression, anxiety, and pain are common traumatic brain injury comorbidities with substantial influence on sleep quality. Diagnosis of sleep disorder after traumatic brain injury may involve polysomnography, multiple sleep latency testing, and/or actigraphy. Treatment is disorder-specific and may include the use of medications, continuous positive airway pressure (or similar device), and/or behavioral modifications. Unfortunately, treatment of sleep disorders associated with traumatic brain injury often does not improve sleepiness or neuropsychological function.

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