Sleep and quality of life in traumatic brain injury and Guillain-Barré Syndrome

Abstract

Sleep disorders in traumatic brain injury include insomnia, disruption of sleep architecture, excessive daytime sleepiness (EDS), and disorders of biological rhythms. Insomnia is common and is an important impediment to successful rehabilitation. Risk factors for insomnia in traumatic brain injury (TBI) include female gender, lesser degrees of injury, depression, and pain. EDS usually appears later in the course of illness than does insomnia. Circadian rhythm disturbances, particularly delayed sleep-phase syndrome, may present as insomnia. A number of reports have described behavioral aberrations in Guillain-Barré syndrome, a condition that targets mainly the peripheral nervous system. Hallucinations and oneiric experiences are among the behaviors seen in Guillain-Barré syndrome (GBS). These phenomena may be associated with reduced hypocretin-1 in the cerebrospinal fluid (csf) and with narcoleptic-like changes on polysomnography (PSG), suggesting the possibility of hypothalamic involvement in GBS. © 2008 Humana Press, Totowa, NJ.