Investigating Sleepiness in People with Complicated and Uncomplicated Mild TBI

Research Objectives: To examine differences in sleepiness between individuals with complicated or uncomplicated mild traumatic brain injury (mTBI). Additionally, this study evaluated differences in the proportion of people with excessive daytime sleepiness (EDS) between mTBI groups.

Design: A secondary data analysis of de-identified archival data from a prospective observational study (Crichton & Singh, 2020).

Setting: Participants were recruited from the general community 6-8 weeks after emergency department discharge.

Participants: Sixty mTBI participants, with 35 uncomplicated and 25 complicated mTBI participants differentiated by positive CT findings. Exclusion criteria: under age 18, history of TBI requiring hospital admission, or any preexisting cognitive impairment.

Interventions: Not applicable.

Main Outcome Measures: Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). An established cut-off (ESS ≥ 10) was used to identify EDS.

Results: There was no difference in sleepiness between mTBI groups, t(58)= 1.15, p= .255. Additionally, there was no association with the presence of EDS and mTBI group, χ²(1, N = 60)= 2.28, p= .131. While there was a greater proportion of individuals over age 50 with complicated mTBI relative to the uncomplicated group, χ²(1, N = 60)= 5.66, p= .017, there was no relationship between age and sleepiness. No other clinico-demographics were relevant to investigating sleepiness across mTBI groups.

Conclusions: The findings suggest that sleepiness and the presence of EDS are not affected by whether a person with mTBI has a positive CT scan. It is important to acknowledge the limited sample size and 6-8 weeks post-injury assessment period used to evaluate differences in sleepiness. Meaningful differences may emerge with a longer follow-up period. Excessive sleepiness is an important clinical concern following TBI that requires further investigation.

Author(s) Disclosures: The authors have no conflicts of interest to disclose.