Observational comparison of fatigue and sleep disturbance after traumatic injury, in those with and without concomitant mild traumatic brain injury

Objective: Fatigue and subjective sleep disturbance are elevated after mild traumatic brain injury (mTBI), raising the question of whether mTBI-specific factors contribute to the experience of fatigue and subjective sleep disturbance after mTBI.

Design: 110 premorbidly healthy individuals who had suffered a traumatic injury during an accident approximately 8 weeks prior were examined and assessed with subjective measures of fatigue and sleep disturbance, psychological distress and pain.

Results: Individuals with a traumatic injury reported significant elevations in most fatigue and all subjective sleep disruption components compared to community-based control participants (n = 45). After controlling for pain, psychological status, sex and premorbid intellectual functioning, those individuals experiencing a mTBI at time of traumatic injury (n = 64) had equivalent levels of fatigue and subjective sleep disruption as those who had experienced no head injury at time of traumatic injury (n = 46). Trauma group membership did not significantly predict fatigue or subjective sleep disturbance. In contrast, psychological distress consistently predicted fatigue and subjective sleep disturbance, with pain also inconsistently predicting some fatigue and subjective sleep disturbance variables.

Conclusion: This study suggests it is the experience of suffering traumatic injury, rather than mTBI-specific factors, that is associated with elevations in fatigue and subjective sleep disturbance, approximately 8 weeks after injury.