Tagged with “sleep disorders”
I have discussed research on the important role of sleep in TBI recovery in prior posts. Accordingly, I have encouraged clients to get help with sleep issues as soon as they become apparent after an injury. Studies have shown that approximately 50% of patients diagnosed with mTBI (“mild traumatic brain injury”) experience chronic sleep disruption. There is evidence that the brain repairs itself during sleep, which is one of the reasons why poor sleep can delay recovery. Poor sleep following a brain injury has been associated with disturbance in the normal rhythm of melatonin production.
A recent double-blind, placebo-controlled study by researchers at the University of Arizona, published in Neurobiology of Disease 134 (2020) 104579 (funded by the US Army Medical Research and Development Command ) demonstrated that morning exposure to blue wavelength light improves sleep quality and leads to measurable cognitive improvements and positive changes in brain anatomy and function as measured by functional and structural MRIs. Read More
There’s promising research on the use of melatonin for acute treatment of traumatic brain injury (TBI) and for treatment of sleep disturbance following TBI coming from two recent peer-reviewed papers. One, published in the Journal of Neurotrauma, reviews the literature and performs meta-analyses of the data in studies examining the use of melatonin shortly after injury.
The other, published in the journal BMC Med, reports on a randomized controlled trial examining the efficacy of melatonin in treating sleep disturbance following TBI.
Melatonin is an important hormone made by the pineal gland that helps control a person’s sleep and wake cycles. Read More
As discussed in prior posts on this blog, sleep alterations are commonly found after a concussion or other traumatic brain injury, both short term and in some cases long term. One of the most well documented impacts of concussion, also discussed in prior posts, is an increased risk of mood disturbances, including depression, increased anxiety and increased risk of suicide. In recent years researchers have turned to sleep studies to explore the connection between these symptoms.
There is substantial evidence in the literature of the role healthy sleep plays in the “consolidation” of emotional memories. At first blush, this research is counter-intuitive. If sleep “consolidates” emotional memories, doesn’t this have the potential to increase rather than decrease mood disturbance? The answer appears to be that, although sleep preserves memory of events associated with emotional experience, at the same time it weakens the emotional “charge” coating the experience (referred to in the literature as “valence”) in a process called “habituation.” As one researcher hypothesized, “we sleep to forget the emotional tone, yet sleep to remember the tagged information.” Read More
A treatment protocol combining Ritalin, a stimulant commonly used for ADHD, and a form of Cognitive Behavioral Rehabilitation known as “Memory and Attention Adaptation Training” (MAAT) shows great promise for improving persistent traumatic brain injury (TBI) symptoms, including attention, episodic and working memory and executive function. The research supporting this finding, led by Thomas McAllister and Brenna McDonald at the Indiana School of Medicine, was published in 2017 in the journal of the American College of Neuropsychopharmacology. Read More
Although the primary focus of this blog is on “traumatic” brain injury, the literature increasingly demonstrates that the physiological causes of cognitive impairment overlap between a range of conditions having neurodegenerative consequences, including TBI, PTSD, Alzheimer’s disease and “Chemobrain”. (Chronic inflammation appears to be one of the common variables, as discussed in prior posts.) Read More
The Radiology Society of North America has published a new study that identifies particular white matter brain injury patterns in patients with persistent depression and anxiety following mild traumatic brain injury (concussion or mTBI.) Read More
In a study published in April 2015 in the medical journal Brain Behavior and Immunity, a team of Canadian researchers at McMaster University presents a new understanding of the cause of the wide-array of symptoms experienced by some patients following concussion, such as headaches, dizziness, sleep disturbance, fatigue, cognitive impairment and neuropsychiatric symptoms.
This new paradigm helps to explain why the same pattern of symptoms can be found in some non-head injury patients, such a patient who has experienced infections or a patient diagnosed with post-traumatic stress disorder. It also helps to explain why some patients recover and others do not and why pre-accident experience can influence the course of post-accident recovery. Read More
Several recent developments demonstrate increasing recognition of the serious potential consequences of concussion, and commitment to minimize those consequences through appropriate treatment of concussion:
Physicians have an ethical obligation to become knowledgeable about concussion.
On June 9, 2014 the American Academy of Neurology, the largest professional association of neurologists, released a position paper stating that doctors have an ethical obligation to educate and protect athletes from sports concussion and clear them to play only when the athlete is medically ready, standing firm against objections from players, athletes and coaches. The statement declares that sports concussion “is a major issue in the world of health care” and requires more attention from physicians. Read More
Two recent peer reviewed papers support the position statement adopted by the Brain Injury Association in 2009 that “Brain Injury” be treated not as static event from which patients gradually recover over time, but as the beginning of a disease process that that can cause symptoms that change over time, in some cases getting worse instead of better, and that can impact multiple organ systems.
The good news is that most people do, in fact, recover. For those who do not, however, the disease model is more consistent with the evolving research. As McCrea, Iverson, McAllister, et. al. noted in their 2009 Integrated Review of Recovery after Mild Traumatic Brain Injury, brain injury science has advanced more in the last few years than in the previous 50, causing us to change the paradigms we have used to understand both the injury and its consequences. Read More
The American Academy of Sleep Medicine has announced the results of a recent study showing that bright light therapy following Mild TBI (concussion) may improve sleep, cognitive and brain function. The study results were presented at the June 3, 2013 meeting of the Associated Professional Sleep Societies LLC and published in an online supplement to the journal Sleep. Read More