New Study Suggests Potential Factors Associated with Insomnia Progression in TBI Patients

FJ Thomas

Sarasota, FL ( – Many people struggle to get 7 hours or more of quality sleep. Statistics from the CDC show that depending on region, up to 44 percent of the adult population suffers from insomnia.

While sleep quality is a critical factor in staying healthy the workplace, it is a critical factor for patients that have a Traumatic brain injury (TBI). Every year, at least 2.5 million adults are treated for TBIs. While TBI patients are often plagued with a whole host of issues such as cognition impairment, fatigue, chronic pain, depression, and PTSD, one of the most common complaints is insomnia. Insomnia can exacerbate TBI accompanying issues, and some studies show that sleep quality has a direct effect on neurodegeneration, and select measures of executive function in TBI patients, as well as overall outcomes.

Half of patients that have experienced a TBI will suffer from some type of sleep issue, and as many as 29 percent will actually be diagnosed with a sleep disorder. Additionally, some studies have shown that patients with TBIs report insomnia as one of their most troubling problems.

In a study published last month in JAMA Network Open, researchers from the University of Maryland School of Medicine, Baltimore asked the question what is the natural history of insomnia in the 12 months after a TBI? The researchers identified 5 classes or paths of insomnia, with baseline factors that included sex, race, ethnicity, the history of the TBI, psychiatric profile, and computed tomography profile.

A total of 2,022 participants were analyzed from the large studyTransforming Research and Clinical Knowledge in Traumatic Brain Injury, also known as TRACK-TBI. Participants in the TRACK-TBI study were enrolled within 24 hours, with a series of assessments at 2 weeks and 3, 6, and 12 months thereafter.

Mild class 1 insomnia was reported by 61.6 percent. Of those, 31 percent initially reported mild insomnia that resolved over time, which was a classification 2. Severe persistent insomnia was given a classification 3, of which 4.5 percent reported. A total of 2.2 percent reported severe insomnia that was resolved in 12 months, a classification of 4. Class 5 accounted for .7 percent that initially reported no insomnia, but then developed severe insomnia within the 12-month period.

Those with any psychiatric history had decreased odds of being in class 2 but increased odds of being in class 3. Females had higher odds of being in class 3. Black individuals had decreased odds of being in class 2 but increased odds of being in class 3.

Researchers believe that more work needs to be done to better identify courses of insomnia and their associated factors in order to improve therapy.