Jonathan E. Elliott, PhD1,2; Ryan A. Opel, BS1; Kris B. Weymann, PhD, RN1,3; Alex Q. Chau1; Melissa A. Papesh, PhD1; Megan L. Callahan, PsyD1; Daniel Storzbach, PhD1,2,4; Miranda M. Lim, MD, PhD1,2,5,6,7
1VA Portland Health Care System, Portland, Oregon; 2Department of Neurology, Oregon Health and Science University, Portland, Oregon; 3School of Nursing, Oregon Health and Science University, Portland, Oregon; 4Department of Psychiatry, Oregon Health and Science University, Portland, Oregon; 5Department of Medicine, Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon; 6Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, Oregon; 7Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon
Study Objectives:
Sleep disturbances following traumatic brain injury (TBI) in Veterans are very common and often persist as chronic sequelae. In addition, sensory sensitivity, ie, discomfort upon exposure to light and noise, is common after TBI. However, the relationship between sleep disturbances and sensory sensitivity in Veterans following TBI has not yet been examined, yet both are established early markers of neurodegeneration.
Methods:
Veterans (n = 95) in the chronic phase of recovery from TBI at the VA Portland Health Care System completed an overnight polysomnography and provided self-report data on sensory (eg, light and noise) sensitivity, and sleep disturbances. Participants were categorized into four sensory sensitivity groups: (1) “neither,” neither light nor noise sensitivity (n = 36); (2) “light,” only light sensitivity (n = 12); (3) “noise,” only noise sensitivity (n = 24); and (4) “both,” light and noise sensitivity (n = 23).
Results:
Veterans with TBI reported sleep disturbances that were significantly correlated with the severity of their sensory sensitivity and associated with posttraumatic stress disorder (PTSD). Multiple linear regression revealed insomnia severity to be the strongest predictor of the relationship between sleep disturbances and sensory sensitivity. Furthermore, sensory sensitivity was associated with a higher mean heart rate during sleep, even after controlling for PTSD status.
Conclusions:
These data are the first to report the prevalence and association between sensory sensitivity and sleep disturbances in Veterans with TBI. These data also suggest that the underlying mechanism of the sleep-sensory relationship could be due in part to comorbid PTSD and autonomic nervous system hyperarousal.
Citation:
Elliott JE, Opel RA, Weymann KB, Chau AQ, Papesh MA, Callahan ML, Storzbach D, Lim MM. Sleep disturbances in traumatic brain injury: associations with sensory sensitivity. J Clin Sleep Med. 2018;14(7):1177–1186.