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Sleep in the Acute Phase of Severe Traumatic Brain Injury : A Snapshot of Polysomnography

The onset of pervasive sleep-wake disturbances
associated with traumatic brain injury (TBI) is poorly understood. This study
aimed to (a) determine the feasibility of using polysomnography in patients in
the acute, hospitalized stage of severe TBI and (b) explore sleep quality and
sleep architecture during this stage of recovery, compared to patients with other
traumatic injuries. Methods A cross-sectional case-control design was used. We
examined the sleep of 7 patients with severe TBI (17-47 years; 20.3 +/- 15.0 days
postinjury) and 6 patients with orthopedic and/or spinal cord injuries (OSCI;
19-58 years; 16.9 +/- 4.9 days postinjury). One night of ambulatory
polysomnography was performed at bedside. Results Compared to OSCI patients, TBI
patients showed a significantly longer duration of nocturnal sleep and earlier
nighttime sleep onset. Sleep efficiency was low and comparable in both groups.
All sleep stages were observed in both groups with normal proportions according
to age. Conclusion Patients in the acute stage of severe TBI exhibit increased
sleep duration and earlier sleep onset, suggesting that the injured brain
enhances sleep need and/or decreases the ability to maintain wakefulness. As poor
sleep efficiency could compromise brain recovery, further studies should
investigate whether strategies known to optimize sleep in healthy individuals are
efficacious in acute TBI. While there are several inherent challenges,
polysomnography is a useful means of examining sleep in the early stage of
recovery in patients with severe TBI.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS

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