Abstract
Background: Concussion symptoms typically resolve within 7–10 days, but 10–25% of patients do not fully recover. They can develop post-concussion syndrome (PCS), which includes sleep abnormalities such as obstructive sleep apnea. It is unclear how specific sleep problems manifest in PCS and how it relates to cognition and symptomology. Methods: A retrospective chart review was conducted on PCS patients seen at the University Health Network (UHN) Concussion Clinic and sent for sleep study. Neuropsychology tests, concussion features, PCS symptoms, and demographics were abstracted from clinical charts. Sleep measures were abstracted from the overnight sleep study. Data were analyzed using chi-squared tests and linear regression. Results: Fifty-one patients completed the sleep study; 78% of these were diagnosed with sleep apnea. Patients with sleep apnea reported significantly more memory symptoms. A trend existed for higher total symptom number. Age was significantly different between the two groups. Women and men were equally at risk of being diagnosed with sleep apnea. Conclusions: Sleep apnea is common in PCS patients complaining of non-restorative sleep and/or waking up with headaches. Sleep apnea was associated with more memory symptoms. PCS patients are at higher risk for sleep apnea and sleep study should be considered if complaining of non-restorative sleep and/or waking up with headaches, regardless of sex and other known risk factors.
Highlights
Concussion or mild traumatic brain injury is the most common form of traumatic brain injury [1]
There were no significant differences between the post-concussion syndrome (PCS) patients with and without sleep apnea with respect to sex distribution, concussion number, and mechanism of injury with the most to the least common mechanism being motor vehicle accidents, trauma, and sports in both groups
Our results demonstrate that a majority of people with PCS who were sent for and completed a sleep study were diagnosed with some form of sleep apnea, The sleep apnea prevalence across all brain injury severities is 25% [7] and our estimated value of 11.3% in the PCS population indicates a lower prevalence, but still higher than the general population (6.4%) [9]
Summary
Concussion or mild traumatic brain injury (mTBI) is the most common form of traumatic brain injury [1]. Patients with PCS can have a variety of symptoms including physical symptoms (e.g., headaches, dizziness, difficulty with balance, tinnitus), cognitive symptoms (e.g., memory impairment, executive dysfunction, attention deficits), and emotional symptoms (e.g., depression, anxiety) [1,4]. Sleep abnormalities such as insomnia, hypersomnia, and sleep apnea [5] are frequently observed in PCS patients [6,7]. Concussion symptoms typically resolve within 7–10 days, but 10–25% of patients do not fully recover They can develop post-concussion syndrome (PCS), which includes sleep abnormalities such as obstructive sleep apnea. PCS patients are at higher risk for sleep apnea and sleep study should be considered if complaining of non-restorative sleep and/or waking up with headaches, regardless of sex and other known risk factors
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