How to Improve Sleep Quality & Fight Fatigue after a TBI: New Study Reveals Important InsightsAugust 10, 2017
Traumatic brain injury (TBI) can be marked by a range of physical, cognitive and emotional symptoms. While these symptoms can vary according to the severity of the TBI (and patient-specific factors), two of the most prevalent symptoms experienced by TBI patients are sleep problems and fatigue.
In fact, a 2014 TBI study1 found that:
- Nearly 50 percent of TBI patients experience sleeping problems, such as an inability to fall or stay asleep or an increased need for sleep.
- More than 70 percent of TBI patients experience fatigue.
Focused on addressing these TBI symptoms, a recent study2 explored “the experience of fatigue and sleep difficulties over the first 2 years after traumatic brain injury.” The following reveals the important insights uncovered by this study.
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Background on the Study
Conducted on behalf of the TBI Experiences Group, this study included 30 participants between the ages of 16 and 85. All participants, who had sustained a mild to severe TBI within the past 6 months, were interviewed by researchers at 6, 12 and 24 months following injury.
The interviews, described as “semistructured,” lasted between 30 and 75 minutes and:
- Were conducted in the participant’s home or in a private, clinical setting
- Included open ended questions to “ensure that a range of experiences and issues of importance to participants could be identified”
- Specifically asked patients about how they felt at a given stage of recovery, including their perspective on what was (and was not) aiding the recovery process.
Interestingly, researchers did not directly question participants about sleep and fatigue. However, when participants raised these issues, researchers did prompt them to discuss their experiences with sleep and fatigue in more detail.
After analyzing the participants’ interview responses, researchers identified four central themes related to sleep and fatigue experienced by TBI survivors:
- Difficulty making sense of fatigue and sleep issues – Many participants explained that “they felt unprepared for the intensity and persistence of difficulties” and that they were “struggling to understand, accept and manage their fatigue and sleep difficulties even many months or years after their injury.”
- Challenges accepting the need for rest – Many participants also explained that they pushed themselves “too hard” and reached a “braking point before realizing the importance of needing to rest and pace themselves.” Some participants even reported difficulties balancing the need for rest with “the competing demands of everyday life.”
- The importance of learning how to rest – Since no two TBIs are alike and various pre-injury factors can impact the persistence of some TBI symptoms (like fatigue and sleeping problems), researchers noted that each patient should be “individually assessed” so each can learn the best methods to get proper rest (based on the individual’s “life and circumstances”).
- How the need for rest can affect TBI survivors’ ability to engage in life – Another prevailing theme researchers discovered was how sleep and fatigue issues, coupled with the need for rest, impacted TBI survivors’ activity levels and quality of life. While researchers highlighted the importance of “discussing strategies for managing fatigue and sleep difficulties” with patients, they also noted that, “ideally, these strategies would focus on how to gradually increase activity and reduce rest periods, giving people a greater sense of control and reducing some concerns about their long-term dependency on napping.”
Ultimately, researchers concluded that treating sleep and fatigue issues in TBI patients should involve a targeted approach so patients can better “understand, accept and manage the sleep and fatigue difficulties experienced” and more fully engage in everyday life.
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1: Longitudinal follow-up of patients with traumatic brain injury: outcome at two, five, and ten years post-injury, published January 2014
2: Exploring the experience of sleep and fatigue in male and female adults over the 2 years following traumatic brain injury: a qualitative descriptive study, published April 2016