Emotional Factors Could Cause Fatigue and Insomnia in People with Traumatic Brain Injuries

Factors such as anxiety and depression may be the source of the two most common and disabling problems after suffering a TBI: fatigue and insomnia.

New York
 – January 9, 2013 /Press Release/  –– 

A new study shows that factors such as anxiety and depression may be the source of the two most common and disabling problems after suffering a traumatic brain injury (TBI): fatigue and insomnia.

A team of researchers from five institutions led by The Mount Sinai Medical Center found that individuals with TBI who suffer from both fatigue and insomnia have higher rates of anxiety and depression. The study, titled "Insomnia, Fatigue, and Sleepiness in the First 2 Years After Traumatic Brain Injury," is published in the November/December issue of The Journal of Head Trauma Rehabilitation.

"These findings indicate that emotional disturbances play a very important part in these conditions regardless of age or gender or the severity of the injury," said Joshua B. Cantor, PhD, first author of the study and an Associate Professor of Rehabilitation Medicine and Co-Director of the Brain Injury Research Center at The Mount Sinai Medical Center. "That means that we need to manage psychiatric problems well if we want to help reduce the effect of insomnia and fatigue on people with TBI."

Post TBI Fatigue (PTBIF) was associated with greater disability and sleepiness.. Demographic and injury variables were not strong predictors of insomnia or PTBIF. "Surprisingly, we found that a majority of the patients with fatigue did not have insomnia," said Dr. Cantor. "However of those who did have insomnia almost all had fatigue. This suggests that for most people, fatigue after brain injury cannot be accounted for by insomnia."
Dr. Cantor added, "This study shows that more disabled individuals with TBI are at greater risk for fatigue and that we need to be aggressively assessing and managing fatigue in patients with insomnia and with more severe disability."

The research team examined 334 individuals with moderate to severe TBI who completed one- or two-year follow-up interviews between 2008 and 2012. Participants were individuals with TBI enrolled in the National Institute of Disability and Rehabilitation Research TBI Model Systems program (TBIMS) National Database (NDB).

The patients who were studied were enrolled at one of five collaborating TBIMS centers including The Mount Sinai Medical Center; Santa Clara Valley Medical Center in San Jose, California; Kessler Research Foundation in West Orange, New Jersey; Carolinas Rehabilitation in Charlotte, North Carolina; and JFK Johnson Rehabilitation Institute in Edison, New Jersey.

About The Mount Sinai Medical Center

The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai. Established in 1968, the Icahn School of Medicine is one of the leading medical schools in the United States, and is noted for innovation in education, biomedical research, clinical care delivery, and local and global community service. It has more than 3,400 faculty in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National Institutes of Health (NIH) funding and by U.S. News & World Report.

The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation’s oldest, largest and most-respected voluntary hospitals. In 2012, U.S. News & World Report ranked The Mount Sinai Hospital 14th on its elite Honor Roll of the nation’s top hospitals based on reputation, safety, and other patient-care factors.  Mount Sinai is one of 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and by  U.S. News & World Report and whose hospital is on the U.S. News & World Report Honor Roll.  Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place. 

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