Sleep Disturbance and Fatigue: Introduction | Normal Sleep Cycle | Prevalence of Sleep Disorders After TBI | Relationship Between TBI and Sleep | Types of Sleep Disturbances After TBI | Evaluation of Sleep Disturbances After TBI | Treatment of Sleep Disturbances After TBI | Pathophysiology of Fatigue | Prevalence and Correlates of Fatigue After TBI | Evaluation of Fatigue After TBI | Treatment of Fatigue After TBI | Conclusion | Key Clinical Points | Recommended Readings | References
Sleep disturbance and fatigue are two common disabling
symptoms that affect the recovery course and disrupt rehabilitation
in patients who survive traumatic brain injury (TBI). Despite the
ubiquity of these problems, objective data are scarce on the prevalence,
pathophysiology, and treatment of these conditions in the TBI literature.
The exact etiology of these disturbances is also unclear. Sleep
disturbance and fatigue after TBI can be best conceptualized as
primary effects of the trauma itself, which can cause neurohormonal
and neurotransmitter dysfunction in the central nervous system or
as secondary effects of neuropsychiatric disturbances associated
with the TBI. Side effects of medications used to treat TBI and
psychological distress associated with trauma may also influence
sleep cycle integrity. Sleep disturbance and fatigue, although not
well studied after TBI, are common and have important rehabilitation implications
for patients (see Figure 20–1).