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Review
. 2018 Nov 15;35(22):2615-2631.
doi: 10.1089/neu.2017.5243. Epub 2018 Aug 24.

Sleep, Sleep Disorders, and Circadian Health following Mild Traumatic Brain Injury in Adults: Review and Research Agenda

Emerson M Wickwire  1   2 , David M Schnyer  3 , Anne Germain  4 , Scott G Williams  5   6 , Christopher J Lettieri  5   6 , Ashlee B McKeon  4 , Steven M Scharf  2 , Ryan Stocker  7 , Jennifer Albrecht  8 , Neeraj Badjatia  9 , Amy J Markowitz  10 , Geoffrey T Manley  11
Affiliations
Review

Sleep, Sleep Disorders, and Circadian Health following Mild Traumatic Brain Injury in Adults: Review and Research Agenda

Emerson M Wickwire et al. J Neurotrauma. .

Erratum in

Abstract

A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). Although many questions remain unanswered, the preponderance of evidence suggests that sleep and circadian disorders can result from mTBI. Among those with mTBI, sleep disturbances and clinical sleep and circadian disorders contribute to the morbidity and long-term sequelae across domains of functional outcomes and quality of life. Specifically, along with deterioration of neurocognitive performance, insufficient and disturbed sleep can precede, exacerbate, or perpetuate many of the other common sequelae of mTBI, including depression, post-traumatic stress disorder, and chronic pain. Further, sleep and mTBI share neurophysiologic and neuroanatomic mechanisms that likely bear directly on success of rehabilitation following mTBI. For these reasons, focus on disturbed sleep as a modifiable treatment target has high likelihood of improving outcomes in mTBI. Here, we review relevant literature and present a research agenda to 1) advance understanding of the reciprocal relationships between sleep and circadian factors and mTBI sequelae and 2) advance rapidly the development of sleep-related treatments in this population.

Keywords: circadian; concussion; insomnia; sleep; sleep disorders; traumatic brain injury.

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Conflict of interest statement

EMW's institution has received research funding from Merck and ResMed. EMW has moderated non-commercial scientific discussion and served as a scientific consultant for Merck and is an equity shareholder in WellTap. SMS's institution has received research funding from Merck and ResMed. DMS, AG, SGW, CJL, ABM, JA, RS, NB, AM, and GTM have no conflicts to disclose.

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