Prospective Evaluation of the Nature, Course, and Impact of Acute Sleep Abnormality After Traumatic Brain Injury
Abstract Objective To prospectively characterize the prevalence, course, and impact of acute sleep abnormality among traumatic brain injury (TBI) neurorehabilitation admissions. Design Prospective observational study. Setting Freestanding rehabilitation hospital. Participants Primarily severe TBI (m...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2013-05, Vol.94 (5), p.875-882 |
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| creator | Nakase-Richardson, Risa, PhD Sherer, Mark, PhD Barnett, Scott D., PhD Yablon, Stuart A., MD Evans, Clea C., PhD Kretzmer, Tracy, PhD Schwartz, Daniel J., MD Modarres, Mo, PhD |
| description | Abstract Objective To prospectively characterize the prevalence, course, and impact of acute sleep abnormality among traumatic brain injury (TBI) neurorehabilitation admissions. Design Prospective observational study. Setting Freestanding rehabilitation hospital. Participants Primarily severe TBI (median emergency department Glasgow Coma Scale [GCS] score=7; N=205) patients who were mostly men (71%) and white (68%) were evaluated during acute neurorehabilitation. Interventions None. Main Outcome Measure Delirium Rating Scale-Revised-98 (DelRS-R98) was administered weekly throughout rehabilitation hospitalization. DelRS-R98 item 1 was used to classify severity of sleep-wake cycle disturbance (SWCD) as none, mild, moderate, or severe. SWCD ratings were analyzed both serially and at 1 month postinjury. Results For the entire sample, 66% (mild to severe) had SWCD at 1 month postinjury. The course of the SWCD using a subset (n=152) revealed that 84% had SWCD on rehabilitation admission, with 63% having moderate to severe ratings (median, 24d postinjury). By the third serial exam (median, 35d postinjury), 59% remained with SWCD, and 28% had moderate to severe ratings. Using general linear modeling and adjusting for age, emergency department GCS score, and days postinjury, presence of moderate to severe SWCD at 1 month postinjury made significant contributions in predicting duration of posttraumatic amnesia ( P |
| doi_str_mv | 10.1016/j.apmr.2013.01.001 |
| format | Article |
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Design Prospective observational study. Setting Freestanding rehabilitation hospital. Participants Primarily severe TBI (median emergency department Glasgow Coma Scale [GCS] score=7; N=205) patients who were mostly men (71%) and white (68%) were evaluated during acute neurorehabilitation. Interventions None. Main Outcome Measure Delirium Rating Scale-Revised-98 (DelRS-R98) was administered weekly throughout rehabilitation hospitalization. DelRS-R98 item 1 was used to classify severity of sleep-wake cycle disturbance (SWCD) as none, mild, moderate, or severe. SWCD ratings were analyzed both serially and at 1 month postinjury. Results For the entire sample, 66% (mild to severe) had SWCD at 1 month postinjury. The course of the SWCD using a subset (n=152) revealed that 84% had SWCD on rehabilitation admission, with 63% having moderate to severe ratings (median, 24d postinjury). By the third serial exam (median, 35d postinjury), 59% remained with SWCD, and 28% had moderate to severe ratings. Using general linear modeling and adjusting for age, emergency department GCS score, and days postinjury, presence of moderate to severe SWCD at 1 month postinjury made significant contributions in predicting duration of posttraumatic amnesia ( P <.01) and rehabilitation hospital length of stay ( P <.01). Conclusions Results suggest that sleep abnormalities after TBI are prevalent and decrease over time. However, a high percent remained with SWCD throughout the course of rehabilitation intervention. Given the brevity of inpatient neurorehabilitation, future studies may explore targeting SWCD to improve early outcomes, such as cognitive functioning and economic impact, after TBI.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2013.01.001</identifier><identifier>PMID: 23296143</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Disease ; Adult ; Amnesia - etiology ; Amnesia - psychology ; Brain injuries ; Brain Injuries - complications ; Brain Injuries - rehabilitation ; Delirium ; Female ; Glasgow Coma Scale ; Humans ; Length of Stay ; Linear Models ; Male ; Middle Aged ; Outcome assessment (health care) ; Physical Medicine and Rehabilitation ; Prospective Studies ; Rehabilitation ; Sleep ; Sleep Initiation and Maintenance Disorders - etiology ; Sleep Initiation and Maintenance Disorders - psychology ; Time Factors ; Young Adult</subject><ispartof>Archives of physical medicine and rehabilitation, 2013-05, Vol.94 (5), p.875-882</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2013 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-a830cb6e8ab454326e072038b66518f43fac22f185c94a4361f9f619e017c4da3</citedby><cites>FETCH-LOGICAL-c411t-a830cb6e8ab454326e072038b66518f43fac22f185c94a4361f9f619e017c4da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.apmr.2013.01.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23296143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakase-Richardson, Risa, PhD</creatorcontrib><creatorcontrib>Sherer, Mark, PhD</creatorcontrib><creatorcontrib>Barnett, Scott D., PhD</creatorcontrib><creatorcontrib>Yablon, Stuart A., MD</creatorcontrib><creatorcontrib>Evans, Clea C., PhD</creatorcontrib><creatorcontrib>Kretzmer, Tracy, PhD</creatorcontrib><creatorcontrib>Schwartz, Daniel J., MD</creatorcontrib><creatorcontrib>Modarres, Mo, PhD</creatorcontrib><title>Prospective Evaluation of the Nature, Course, and Impact of Acute Sleep Abnormality After Traumatic Brain Injury</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Objective To prospectively characterize the prevalence, course, and impact of acute sleep abnormality among traumatic brain injury (TBI) neurorehabilitation admissions. Design Prospective observational study. Setting Freestanding rehabilitation hospital. Participants Primarily severe TBI (median emergency department Glasgow Coma Scale [GCS] score=7; N=205) patients who were mostly men (71%) and white (68%) were evaluated during acute neurorehabilitation. Interventions None. Main Outcome Measure Delirium Rating Scale-Revised-98 (DelRS-R98) was administered weekly throughout rehabilitation hospitalization. DelRS-R98 item 1 was used to classify severity of sleep-wake cycle disturbance (SWCD) as none, mild, moderate, or severe. SWCD ratings were analyzed both serially and at 1 month postinjury. Results For the entire sample, 66% (mild to severe) had SWCD at 1 month postinjury. The course of the SWCD using a subset (n=152) revealed that 84% had SWCD on rehabilitation admission, with 63% having moderate to severe ratings (median, 24d postinjury). By the third serial exam (median, 35d postinjury), 59% remained with SWCD, and 28% had moderate to severe ratings. Using general linear modeling and adjusting for age, emergency department GCS score, and days postinjury, presence of moderate to severe SWCD at 1 month postinjury made significant contributions in predicting duration of posttraumatic amnesia ( P <.01) and rehabilitation hospital length of stay ( P <.01). Conclusions Results suggest that sleep abnormalities after TBI are prevalent and decrease over time. However, a high percent remained with SWCD throughout the course of rehabilitation intervention. Given the brevity of inpatient neurorehabilitation, future studies may explore targeting SWCD to improve early outcomes, such as cognitive functioning and economic impact, after TBI.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Amnesia - etiology</subject><subject>Amnesia - psychology</subject><subject>Brain injuries</subject><subject>Brain Injuries - complications</subject><subject>Brain Injuries - rehabilitation</subject><subject>Delirium</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outcome assessment (health care)</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Prospective Studies</subject><subject>Rehabilitation</subject><subject>Sleep</subject><subject>Sleep Initiation and Maintenance Disorders - etiology</subject><subject>Sleep Initiation and Maintenance Disorders - psychology</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9r3DAQxUVpaLZJv0APRccealcj2bINpbBdknQhpIUk0JuQ5TGV63-R5IX99pXZtIceepoZeO_B_B4hb4GlwEB-7FI9Dy7lDETKIGUMXpAN5IInJYcfL8mGMSaSqqrEOXntfRdPmQt4Rc654JWETGzI_N1NfkYT7AHp1UH3iw52GunU0vAT6Z0Oi8MPdDctzsepx4buh1mbsCq2ZglI73vEmW7rcXKD7m040m0b0NEHp5chphn6xWk70v3YLe54Sc5a3Xt88zwvyOP11cPua3L77Wa_294mJgMIiS4FM7XEUtdZngkukRWcibKWMoeyzUSrDectlLmpMp0JCW3VSqiQQWGyRosL8v6UO7vpaUEf1GC9wb7XI06LVyAymRdFUYoo5SepiSy8w1bNzg7aHRUwtZJWnVpJq5W0YqAi6Wh695y_1AM2fy1_0EbBp5MA45cHi055Y3E02FgXeatmsv_P__yP3fR2tEb3v_CIvouFjJGfAuW5Yup-7XqtGkTcGJfiN_i0o5w</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Nakase-Richardson, Risa, PhD</creator><creator>Sherer, Mark, PhD</creator><creator>Barnett, Scott D., PhD</creator><creator>Yablon, Stuart A., MD</creator><creator>Evans, Clea C., PhD</creator><creator>Kretzmer, Tracy, PhD</creator><creator>Schwartz, Daniel J., MD</creator><creator>Modarres, Mo, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>Prospective Evaluation of the Nature, Course, and Impact of Acute Sleep Abnormality After Traumatic Brain Injury</title><author>Nakase-Richardson, Risa, PhD ; Sherer, Mark, PhD ; Barnett, Scott D., PhD ; Yablon, Stuart A., MD ; Evans, Clea C., PhD ; Kretzmer, Tracy, PhD ; Schwartz, Daniel J., MD ; Modarres, Mo, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-a830cb6e8ab454326e072038b66518f43fac22f185c94a4361f9f619e017c4da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Amnesia - etiology</topic><topic>Amnesia - psychology</topic><topic>Brain injuries</topic><topic>Brain Injuries - complications</topic><topic>Brain Injuries - rehabilitation</topic><topic>Delirium</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outcome assessment (health care)</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Prospective Studies</topic><topic>Rehabilitation</topic><topic>Sleep</topic><topic>Sleep Initiation and Maintenance Disorders - etiology</topic><topic>Sleep Initiation and Maintenance Disorders - psychology</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakase-Richardson, Risa, PhD</creatorcontrib><creatorcontrib>Sherer, Mark, PhD</creatorcontrib><creatorcontrib>Barnett, Scott D., PhD</creatorcontrib><creatorcontrib>Yablon, Stuart A., MD</creatorcontrib><creatorcontrib>Evans, Clea C., PhD</creatorcontrib><creatorcontrib>Kretzmer, Tracy, PhD</creatorcontrib><creatorcontrib>Schwartz, Daniel J., MD</creatorcontrib><creatorcontrib>Modarres, Mo, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakase-Richardson, Risa, PhD</au><au>Sherer, Mark, PhD</au><au>Barnett, Scott D., PhD</au><au>Yablon, Stuart A., MD</au><au>Evans, Clea C., PhD</au><au>Kretzmer, Tracy, PhD</au><au>Schwartz, Daniel J., MD</au><au>Modarres, Mo, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective Evaluation of the Nature, Course, and Impact of Acute Sleep Abnormality After Traumatic Brain Injury</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>94</volume><issue>5</issue><spage>875</spage><epage>882</epage><pages>875-882</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>Abstract Objective To prospectively characterize the prevalence, course, and impact of acute sleep abnormality among traumatic brain injury (TBI) neurorehabilitation admissions. Design Prospective observational study. Setting Freestanding rehabilitation hospital. Participants Primarily severe TBI (median emergency department Glasgow Coma Scale [GCS] score=7; N=205) patients who were mostly men (71%) and white (68%) were evaluated during acute neurorehabilitation. Interventions None. Main Outcome Measure Delirium Rating Scale-Revised-98 (DelRS-R98) was administered weekly throughout rehabilitation hospitalization. DelRS-R98 item 1 was used to classify severity of sleep-wake cycle disturbance (SWCD) as none, mild, moderate, or severe. SWCD ratings were analyzed both serially and at 1 month postinjury. Results For the entire sample, 66% (mild to severe) had SWCD at 1 month postinjury. The course of the SWCD using a subset (n=152) revealed that 84% had SWCD on rehabilitation admission, with 63% having moderate to severe ratings (median, 24d postinjury). By the third serial exam (median, 35d postinjury), 59% remained with SWCD, and 28% had moderate to severe ratings. Using general linear modeling and adjusting for age, emergency department GCS score, and days postinjury, presence of moderate to severe SWCD at 1 month postinjury made significant contributions in predicting duration of posttraumatic amnesia ( P <.01) and rehabilitation hospital length of stay ( P <.01). Conclusions Results suggest that sleep abnormalities after TBI are prevalent and decrease over time. However, a high percent remained with SWCD throughout the course of rehabilitation intervention. Given the brevity of inpatient neurorehabilitation, future studies may explore targeting SWCD to improve early outcomes, such as cognitive functioning and economic impact, after TBI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23296143</pmid><doi>10.1016/j.apmr.2013.01.001</doi><tpages>8</tpages></addata></record> |
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| subjects | Acute Disease Adult Amnesia - etiology Amnesia - psychology Brain injuries Brain Injuries - complications Brain Injuries - rehabilitation Delirium Female Glasgow Coma Scale Humans Length of Stay Linear Models Male Middle Aged Outcome assessment (health care) Physical Medicine and Rehabilitation Prospective Studies Rehabilitation Sleep Sleep Initiation and Maintenance Disorders - etiology Sleep Initiation and Maintenance Disorders - psychology Time Factors Young Adult |
| title | Prospective Evaluation of the Nature, Course, and Impact of Acute Sleep Abnormality After Traumatic Brain Injury |
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