Excessive Daytime Sleepiness Is Common After Traumatic Brain Injury

woman holding head in bed

Many people who have sustained traumatic brain injury (TBI) experience sleep-wake disturbances during the recovery period. These disturbances commonly include insomnia, an increased need for sleep, trouble sleeping through the night, and excessive daytime sleepiness (EDS). Although all of these sleep disorders can be frustrating or even debilitating, excessive daytime sleepiness in particular may interfere with a person’s ability to carry out daily tasks, remain productive at work, or safely operate a vehicle. Such impairments tend to exacerbate existing complications related to TBI and reduce quality of life during the injury recovery period.

Scientists know that EDS is fairly common among people with TBI, but existing large-scale research studies have not reached a consensus about the prevalence of EDS: estimates range broadly from 12% to 93% of TBI patients affected by this sleep disturbance. Dissatisfied with these varying results, a research team in the United Kingdom aimed to conclusively determine the prevalence of EDS among people recovering from TBI.

The research team assessed 118 patients who sustained TBI six to eight weeks prior to the study. In a neurorehabilitation clinic setting, the participants completed the Epworth Sleepiness Scale (a reliable measure of sleepiness) and other assessments of their ability to work, their employment status, symptom severity, and other health outcomes. After analyzing the results, the researchers found that:

  • Nearly half (41.7%) of patients met the Epworth Sleepiness Scale criteria for EDS.
  • Compared to those without EDS, participants who did experience EDS were more likely to suffer from anxiety and depression, report reduced productivity at work, and show worse social and functional outcomes.
  • Anxiety was the strongest predictor of EDS.

These results indicate that a significant proportion of people with TBI will experience EDS in the weeks and months following injury, which may interfere with their ability to work, socialize, and engage in everyday activities. Because anxiety in particular may predict EDS, the researchers encourage clinicians to assess all TBI patients for anxiety and to proactively provide their anxious patients with additional sleep-related supports and services.

Crichton T, Sing R, Abosi-Appeadu K, & Dennis G. Excessive daytime sleepiness after traumatic brain injury. Brain Injury. (August 2020).

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