Fatigue is associated with insomnia and depression after traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Some studies estimate that up to 74% of individuals who sustained TBI will experience fatigue, a common complication associated with head injury. Fatigue is known to negatively affect social, cognitive, and physical functioning, which can seriously reduce an individual’s quality of life. During the recovery period, quality of life may also be limited by conditions such as insomnia and depression, which are also commonly reported following TBI. Although these symptoms seem to be related, the exact association between fatigue, insomnia, and depression among TBI patients is not fully understood.

To investigate this relationship, a group of researchers in India collected data from 100 adults who were admitted to the hospital with a TBI. The researchers conducted individual interviews to obtain comprehensive medical histories from each participant, asking the participants about their experience with TBI, fatigue, insomnia, and depression. The severity of each condition was scored on the Glasgow Coma Scale (GCS; a measure of TBI severity), the Fatigue Severity Scale (FSS), the Insomnia Severity Index (ISI), and the Patient Health Questionnaire-9 (PHQ-9), respectively. After analyzing the data, the researchers found that:

  • A large proportion (84%) of partients experienced depression as a result of TBI. About half of patients experienced fatigue or insomnia.
  • All patients who reported fatigue also experienced depression, indicating a strong association between the two conditions.
  • Although not all patients with insomnia experienced fatigue, most patients with fatigue reported experiencing insomnia.

Although further research is necessary to entirely understand the mechanisms underlying fatigue, researchers know that TBI-related fatigue, insomnia, and depression are closely related. Because of the significant associations among these conditions, clinicians are urged to consider all three together when formulating treatment plants for patients with TBI, ensuring that these individuals return more fully to a normal quality of life.

Tomar S, Sharma A, Jain A, et al. Study of fatigue and associated factors in traumatic brain injury and its correlation with insomnia and depression. Asian Journal of Neurosurgery. (October 2018).


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