Association of sleep with neurobehavioral impairments during inpatient rehabilitation after traumatic brain injury

Mithra B. Maneyapanda, Ryan Stork, Benjamin Ingraham, Luca Lonini, Arun Jayaraman, Nicholas Shawen, David Lawrence Ripley*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Sleep disturbance is a common sequela after traumatic brain injury (TBI). Many of the impairments following TBI may be exacerbated by impaired sleep-wake cycle regulation. Objectives: To investigate the relationship between total sleep time (TST), measured by wrist actigraphy and observational sleep logs, and neurobehavioral impairments during inpatient rehabilitation after TBI. Methods: Twenty-five subjects undergoing inpatient rehabilitation for traumatic brain injury were included. TST was measured using wrist actigraphy and observational sleep logs. Neurobehavioral impairments were assessed using the Neurobehavioral Rating Scale-Revised (NRS-R), a multidimensional clinician-based assessment. Results: Of 25 subjects enrolled, 23 subjects completed the study. A significant negative correlation was found between total NRS-R and TST calculated by observational sleep logs (r = -0.28, p = 0.007). The association between total NRS-R and TST, as calculated by actigraphy, was not significantly correlated (R = -0.01, p = 0.921). Conclusions: Sleep disturbance during inpatient rehabilitation is associated with neurobehavioral impairments after TBI. TST measured by actigraphy may be limited by sleep detection algorithms that have not been validated in certain patient populations. Considerations should be made regarding the feasibility of using wearable sensors in patients with cognitive and behavioral impairments. Challenges regarding actigraphy for sleep monitoring in the brain injury population are discussed.

Original languageEnglish (US)
Pages (from-to)319-325
Number of pages7
JournalNeuroRehabilitation
Volume43
Issue number3
DOIs
StatePublished - Jan 1 2018

Fingerprint

Inpatients
Sleep
Rehabilitation
Actigraphy
Wrist
Traumatic Brain Injury
Polysomnography
Brain Injuries
Population

Keywords

  • Sleep
  • actigraphy
  • traumatic brain injury

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

Cite this

Maneyapanda, Mithra B. ; Stork, Ryan ; Ingraham, Benjamin ; Lonini, Luca ; Jayaraman, Arun ; Shawen, Nicholas ; Ripley, David Lawrence. / Association of sleep with neurobehavioral impairments during inpatient rehabilitation after traumatic brain injury. In: NeuroRehabilitation. 2018 ; Vol. 43, No. 3. pp. 319-325.
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abstract = "Background: Sleep disturbance is a common sequela after traumatic brain injury (TBI). Many of the impairments following TBI may be exacerbated by impaired sleep-wake cycle regulation. Objectives: To investigate the relationship between total sleep time (TST), measured by wrist actigraphy and observational sleep logs, and neurobehavioral impairments during inpatient rehabilitation after TBI. Methods: Twenty-five subjects undergoing inpatient rehabilitation for traumatic brain injury were included. TST was measured using wrist actigraphy and observational sleep logs. Neurobehavioral impairments were assessed using the Neurobehavioral Rating Scale-Revised (NRS-R), a multidimensional clinician-based assessment. Results: Of 25 subjects enrolled, 23 subjects completed the study. A significant negative correlation was found between total NRS-R and TST calculated by observational sleep logs (r = -0.28, p = 0.007). The association between total NRS-R and TST, as calculated by actigraphy, was not significantly correlated (R = -0.01, p = 0.921). Conclusions: Sleep disturbance during inpatient rehabilitation is associated with neurobehavioral impairments after TBI. TST measured by actigraphy may be limited by sleep detection algorithms that have not been validated in certain patient populations. Considerations should be made regarding the feasibility of using wearable sensors in patients with cognitive and behavioral impairments. Challenges regarding actigraphy for sleep monitoring in the brain injury population are discussed.",
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Association of sleep with neurobehavioral impairments during inpatient rehabilitation after traumatic brain injury. / Maneyapanda, Mithra B.; Stork, Ryan; Ingraham, Benjamin; Lonini, Luca; Jayaraman, Arun; Shawen, Nicholas; Ripley, David Lawrence.

In: NeuroRehabilitation, Vol. 43, No. 3, 01.01.2018, p. 319-325.

Research output: Contribution to journalArticle

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T1 - Association of sleep with neurobehavioral impairments during inpatient rehabilitation after traumatic brain injury

AU - Maneyapanda, Mithra B.

AU - Stork, Ryan

AU - Ingraham, Benjamin

AU - Lonini, Luca

AU - Jayaraman, Arun

AU - Shawen, Nicholas

AU - Ripley, David Lawrence

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N2 - Background: Sleep disturbance is a common sequela after traumatic brain injury (TBI). Many of the impairments following TBI may be exacerbated by impaired sleep-wake cycle regulation. Objectives: To investigate the relationship between total sleep time (TST), measured by wrist actigraphy and observational sleep logs, and neurobehavioral impairments during inpatient rehabilitation after TBI. Methods: Twenty-five subjects undergoing inpatient rehabilitation for traumatic brain injury were included. TST was measured using wrist actigraphy and observational sleep logs. Neurobehavioral impairments were assessed using the Neurobehavioral Rating Scale-Revised (NRS-R), a multidimensional clinician-based assessment. Results: Of 25 subjects enrolled, 23 subjects completed the study. A significant negative correlation was found between total NRS-R and TST calculated by observational sleep logs (r = -0.28, p = 0.007). The association between total NRS-R and TST, as calculated by actigraphy, was not significantly correlated (R = -0.01, p = 0.921). Conclusions: Sleep disturbance during inpatient rehabilitation is associated with neurobehavioral impairments after TBI. TST measured by actigraphy may be limited by sleep detection algorithms that have not been validated in certain patient populations. Considerations should be made regarding the feasibility of using wearable sensors in patients with cognitive and behavioral impairments. Challenges regarding actigraphy for sleep monitoring in the brain injury population are discussed.

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