One of the very significant problems arising from TBI is that the biological rhythm of sleep is disrupted. A majority of victims of TBI express difficulty in sleeping, altered sleep pattern or need to sleep an unusually long amount following injury.
A recent study published in Chest (Castriotta, RJ 2005) found that almost half of the TBI population can be expected to have a sleep disorder, with obstructive sleep apnea being the leading cause. A meta-analysis (Orff, HJ, et al 2009) found that following TBI, especially mild TBI, there are frequent complaints of sleep disturbance. They found that sleep disturbance complicates recovery and the resolution of symptoms. They noted "research now seems to indicate that mild TBI may be more correlated with increased likelihood of sleep disturbance than are severe forms of TBI". A study from 2008 (Makley, MJ, et al) found that 68% of TBI patients had disturbances of night time sleep. There was no relationship between the severity of initial injury and the prevalence of sleep disorder. People suffering from Sleep Awake Cycle Disturbance (SWCD) have longer stays in both acute and rehabilitative settings and this may be a marker for more severe injury.
The problems with sleep deprivation are that it causes a decrease in cognitive ability, an increase in irritability and in many other ways can give symptoms similar to those from TBI itself. If those TBI symptoms are already present it can tend to aggravate them. Therefore, patients who experience problems in sleep need to get those problems addressed by referral to a specialist. This type of disorder needs to be determined and then a treatment plan enacted.
Lack of sleep is known to depress scores of neuropsychological tests batteries. Thus, someone in the grips of a terrible sleep pattern is likely to show more severe cognitive deficits than they actually have. Therefore, it is important to inform treating physicians and experts that one is sleeping poorly to insure that information will be factored into the diagnosis and treatment. It is also known that sleep depravation effects other common psychological disturbances from TBI including depression and anxiety.