TY - JOUR
T1 - Association Between Insomnia and Mental Health and Neurocognitive Outcomes Following Traumatic Brain Injury
AU - Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Investigators
AU - Wickwire, Emerson M.
AU - Albrecht, Jennifer S.
AU - Capaldi, Vincent F.
AU - Jain, Sonia
AU - Gardner, Raquel C.
AU - Smith, Michael T.
AU - Williams, Scott G.
AU - Collen, Jacob
AU - Schnyer, David M.
AU - Giacino, Joseph T.
AU - Nelson, Lindsay D.
AU - Mukherjee, Pratik
AU - Sun, Xiaoying
AU - Werner, J. Kent
AU - Mosti, Caterina B.
AU - Markowitz, Amy J.
AU - Manley, Geoffrey T.
AU - Krystal, Andrew D.
N1 - Publisher Copyright:
© Mary Ann Liebert, Inc.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - We previously described five trajectories of insomnia (each defined by a distinct pattern of insomnia severity over 12 months following traumatic brain injury [TBI]). Our objective in the present study was to estimate the association between insomnia trajectory status and trajectories of mental health and neurocognitive outcomes during the 12 months after TBI. In this study, participants included N = 2022 adults from the Federal Inter-agency Traumatic Brain Injury Repository database and Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. The following outcome measures were assessed serially at 2 weeks, and 3, 6, and 12 months post-injury: Insomnia Severity Index, Patient Health Questionnaire, Post-Traumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Patient Reported Outcomes Measurement Information System-Pain, and Quality of Life After Brain Injury-Overall Scale. Neurocognitive performance was assessed at 2 weeks, and 6 and 12 months using the Wechsler Adult Intelligence Scales Processing Speed Index and the Trails Making Test Parts A and B. Results indicated that greater insomnia severity was associated with greater abnormality in mental health, quality of life, and neuropsychological testing outcomes. The pattern of insomnia over time tracked the temporal pattern of all these outcomes for all but a very small number of participants. Notably, severe insomnia at 3 or 6 months post-TBI was a risk factor for poor recovery at 12 months post-injury. In conclusion, in this well-characterized sample of individuals with TBI, insomnia severity generally tracked severity of depression, pain, PTSD, quality of life, and neurocognitive outcomes over 12 months post-injury. More intensive sleep assessment is needed to elucidate the nature of these relationships and to help inform best strategies for intervention.
AB - We previously described five trajectories of insomnia (each defined by a distinct pattern of insomnia severity over 12 months following traumatic brain injury [TBI]). Our objective in the present study was to estimate the association between insomnia trajectory status and trajectories of mental health and neurocognitive outcomes during the 12 months after TBI. In this study, participants included N = 2022 adults from the Federal Inter-agency Traumatic Brain Injury Repository database and Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. The following outcome measures were assessed serially at 2 weeks, and 3, 6, and 12 months post-injury: Insomnia Severity Index, Patient Health Questionnaire, Post-Traumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Patient Reported Outcomes Measurement Information System-Pain, and Quality of Life After Brain Injury-Overall Scale. Neurocognitive performance was assessed at 2 weeks, and 6 and 12 months using the Wechsler Adult Intelligence Scales Processing Speed Index and the Trails Making Test Parts A and B. Results indicated that greater insomnia severity was associated with greater abnormality in mental health, quality of life, and neuropsychological testing outcomes. The pattern of insomnia over time tracked the temporal pattern of all these outcomes for all but a very small number of participants. Notably, severe insomnia at 3 or 6 months post-TBI was a risk factor for poor recovery at 12 months post-injury. In conclusion, in this well-characterized sample of individuals with TBI, insomnia severity generally tracked severity of depression, pain, PTSD, quality of life, and neurocognitive outcomes over 12 months post-injury. More intensive sleep assessment is needed to elucidate the nature of these relationships and to help inform best strategies for intervention.
KW - concussion
KW - depression
KW - insomnia
KW - neurocognition
KW - pain
KW - quality of life
KW - trauma
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85174617211&partnerID=8YFLogxK
U2 - 10.1089/neu.2023.0009
DO - 10.1089/neu.2023.0009
M3 - Article
C2 - 37463057
AN - SCOPUS:85174617211
SN - 0897-7151
VL - 40
SP - 2376
EP - 2385
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
IS - 21-22
ER -