Circadian rhythm sleep disorders following mild traumatic brain injury.

Full Abstract

OBJECTIVE: To describe the physiologic and behavioral characteristics of circadian rhythm sleep disorders (CRSDs) following minor traumatic brain injury (mTBI) in patients complaining of insomnia. METHODS: Forty two patients with insomnia complaints following mTBI were screened. Those suspected of having CRSD underwent actigraphy, saliva melatonin and oral temperature measurement, and polysomnography. All patients also filled out a self-reported questionnaire to determine their circadian preference. RESULTS: Fifteen of the 42 patients (36%) with complaints of insomnia following mTBI were diagnosed with CRSD. Eight patients displayed a delayed sleep phase syndrome (DSPS), whereas seven displayed an irregular sleep-wake pattern (ISWP). Whereas all patients with DSPS exhibited a 24-hour periodicity of oral temperature rhythm, three of seven patients with ISWP lacked such a daily rhythm. In addition, ISWP patients exhibited smaller amplitude of oral temperature rhythm vs the DSPS group. Subjective Morningness-Eveningness Questionnaire scores were in accordance with the clinical diagnosis of DSPS or ISWP based on actigraphy. CONCLUSIONS: Minor traumatic brain injury might contribute to the emergence of circadian rhythm sleep disorders. Two types of these disorders were observed: delayed sleep phase syndrome and irregular sleep-wake pattern. The types differed in the subjective questionnaire scores and had distinct profiles of melatonin and temperature circadian rhythms.

Author information

Author/s: Ayalon, L (L); Borodkin, K (K); Dishon, L (L); Kanety, H (H); Dagan, Y (Y);

Affiliation: Department of Psychiatry, University of California San Diego and Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA. layalon(-atsign-)ucsd.edu

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Neurology (Neurology), published in United States. (Language: eng)

Reference: 2007-Apr; vol 68 (issue 14) : pp 1136-40

Dates: Created 2007/04/03; Completed 2007/05/02;

PMID: 17404196, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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