Factors associated with insomnia among post-acute traumatic brain injury survivors

This study investigated the relationships between insomnia and select demog raphic, injury and psychosocial variables in post-acute, traumatic brain in jury. Clinical assessment of sleep and mood was undertaken via objective me asures and a diagnostic interview among 91 consecutive brain injury admissi ons to an outpatient neurorehabilitation clinic. No associations between in somnia and gender, education, age, and time since injury were found. A logi stic regression model of insomnia prediction based upon the Beck Depression Inventory (BDI), sell-reported pain disturbance, litigation and Glasgow Co ma Score (GCS) correctly classified 87% of the sample with respect to the p resence or absence of insomnia; however, depression and injury severity wer e the only variables that made a significant unique contribution to the pre diction of insomnia. It is concluded that among post-acute traumatic brain injury patients, insomnia is linked with both the presence of depression an d a history of milder brain injuries. This suggests that the determinants o f insomnia may differ from the acute to the post-acute phase, with neurolog ical factors playing a primary role early in the recovery process and psych osocial factors ascending later. Therefore, assessment and treatment of ins omnia must give careful attention to the larger psychosocial context in whi ch the sleep disorder emerges, particularly to role of emotional disturbanc e.