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According to a new study published in Neurology, veterans who sustain mild traumatic brain injuries, also known as concussions, are reportedly 49% more likely to develop sleep disorders up to five years after their injuries. Mild TBIs often involve blows to the head that can cause the brain to shift rapidly back and forth inside the skull, leading to inflammation as well as tissue damage in several regions of the brain.
For the study, researchers examined data on almost 200,000 Iraq and Afghanistan-era veterans, roughly half of whom had been diagnosed with a brain injury. Over an average follow-up period of almost five years, 23.4% of the veterans with TBIs developed sleep disorders, compared with 15.8% of the veterans without TBIs.
TBIs were associated with a 50% higher risk of insomnia and what’s known as hypersomnia, or excessive daytime sleepiness, as well as a 33% greater risk for sleep-related movement disorders like restless leg or leg cramps, and a 28% higher risk for sleep-related breathing disorders such as obstructive sleep apnea.
The lead author of the study, Yue Leng, MD, PhD, a psychiatry researcher and an assistant professor at the University of California in San Francisco, said that because leep complaints are common in TBI patients, the new findings are unsurprising. “It is fascinating that there is an increased risk of sleep disorders even years after TBI, not only short-term,” he said.
Leng explained that veterans did have a higher risk of sleep disorders with concussions than with moderate to severe TBIs, which may reflect differences in how these injuries impact the brain.
Per the U.S. Department of Veteran Affairs, the Defense and Veterans Brain Injury Center (DVBIC) reported nearly 414,000 TBIs among U.S. service members worldwide between 2000 and late 2019. More than 185,000 Veterans who use VA for their health care have been diagnosed with at least one TBI. The majority of those TBIs were classified as mild.
Traumatic brain injuries have been linked to lasting sleep issues in previous studies of veterans. For example, a study published in July 2017 in JAMA Neurology found that more than half of veterans with concussions experienced moderate to severe sleep impairment up to five years after their injuries, compared with one in five combat veterans with no history of TBI. Another study from 2018 in the Journal of Clinical Sleep Medicine also linked TBI to sleep disorders in veterans, although this study found the risk was increased when they also had PTSD.
Some things that help with sleep after a concussion are the same things that can help people without brain injuries get a better night’s rest. People recovering from TBIs need to practice what’s known as good sleep hygiene. This means getting eight hours of sleep per night, going to bed at a consistent time, not drinking coffee in the afternoon or evening, and no computer or smartphone use right before bedtime. If sleep problems persist, it may be time to follow up with a specialist who treats concussion patients. The study results suggest that if no sleep issues surface in the weeks or months immediately after a TBI, these injuries could be involved if sleep problems develop down the line.