Sleep apnea in adults with traumatic brain injury: A preliminary investigation

Objective: To determine the occurrence and nature of sleep-related breathin g disorders in adults with traumatic brain injury (TBI). Design: Prospective, observational, consecutive sample en rollment of subje cts admitted for rehabilitation after TBT. Setting: Inpatient rehabilitation and subacute rehabilitation units of a te rtiary care university medical system. Participants: Subjects (n = 28) included adults with TBI and a Rancho Los A migos Scale level of 3 or greater who were less than 3 months postinjury an d admitted for comprehensive inpatient rehabilitation. Interventions: Overn ight sleep study using portable 6-channel monitoring system. Main Outcome Measure: Respiratory disturbance index (RDI), which is the num ber of apneic and hypopneic episodes per hour of sleep. Results: Evidence of sleep apnea was found in 10 of 28 (36%) subjects as me asured by a RDI level of 5 or greater and in 3 of 28 (11%) subjects as meas ured by a RDI level of 10 or greater. This rate of sleep apnea is significa ntly (p = .002) higher than would be predicted based on population norms. N o correlation was found between the occurrence of significant sleep apnea a nd measures of TBI severity or other demographic variables. Sleep-related b reathing disorders were primarily central though obstructive apneas were al so noted. Conclusion: In this preliminary investigation, sleep-related breathing diso rders as defined by a respiratory disturbance index of 5 or greater appears to be common in adult subjects with TBI.