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Circadian rhythm in the assessment of postconcussion insomnia: a cross-sectional observational study
- Source :
- CMAJ Open. 8:E142-E147
- Publication Year :
- 2020
- Publisher :
- CMA Joule Inc., 2020.
-
Abstract
- Background Insomnia is a major predictor of adverse outcomes in mild traumatic brain injury (mTBI), including concussion; although insomnia symptoms may be due to various sleep disorders, those related to circadian rhythm sleep-wake disorders (CRSWDs) require specific assessment and treatment. The objective of the current study was to determine the prevalence of CRSWD in a sample of treatment-seeking people with chronic insomnia symptoms after an mTBI. Methods Participants aged 17-65 years who had experienced an mTBI and reported chronic insomnia were recruited from diverse community clinics in Ontario 3-24 months after their injury to participate in this cross-sectional observational study. Potential participants were screened by both telephone and intake interview. Exclusion criteria were alcohol or substance use disorders, preexisting brain disorder or previous neurosurgery, recent travel across more than 2 time zones or shift work. Assessments included a clinical interview, questionnaires, 2 weeks of actigraphy and a sleep diary, and a dim-light melatonin onset test. The main outcome measure was the proportion of patients with CRSWDs. Results Of the 50 participants (32 [64%] female; median age 39.5 yr), 13 (26% [standard deviation 12%]) had an CRSWD. The most common circadian diagnosis was delayed sleep-wake phase disorder (10 participants [20%]). Interpretation The prevalence of CRSWDs may be exceptionally high among people with chronic insomnia symptoms following mTBI. Proper detection and treatment of CRSWDs in this population is essential to facilitate recovery. The findings emphasize the relevance of a diagnostic circadian assessment in patients with mTBI presenting with chronic insomnia symptoms.
- Subjects :
- Adult
Male
Pediatrics
medicine.medical_specialty
Adolescent
Cross-sectional study
Population
Risk Assessment
Shift work
Young Adult
Risk Factors
Sleep Disorders, Circadian Rhythm
Sleep Initiation and Maintenance Disorders
Surveys and Questionnaires
Concussion
Insomnia
medicine
Humans
education
Brain Concussion
Aged
education.field_of_study
business.industry
Research
Actigraphy
General Medicine
Middle Aged
medicine.disease
Circadian Rhythm
Intake interview
Cross-Sectional Studies
Female
Sleep diary
medicine.symptom
business
Subjects
Details
- ISSN :
- 22910026
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- CMAJ Open
- Accession number :
- edsair.doi.dedup.....4a5953cc4751e993387a6197edfe1010