Associations Between Sleep, Depression, and Traumatic Brain Injury in Ontario Workers With Head Trauma

Abstract

Objective: To investigate the relationship between brain injury, sleep complaints, and other clinical variables following head trauma in Ontario workers. Design: This study utilized a cross-sectional design. Setting: The setting of this study took place at an outpatient clinic within the Neurology Service at the Toronto Rehabilitation Institute-University Health Network (TRI-UHN). Participants: This study consisted of 106 consecutive medical records of Ontario workers who underwent an assessment at the Neurology Service outpatient clinic at Toronto Rehabilitation Institute. Eligible participants for this study included individuals who met the following criteria: (a) older than 18 years of age at the time of injury; (b) injured at work; (c) identified as having sustained a head injury. The research ethics board at the TRI-UHN approved the study. Interventions: N/A Main Outcome Measure(s): N/A Results: Majority of the traumatic brain injury cases was diagnosed as mild. Diagnoses of traumatic brain injury were associated with selfperceived worsening of sleep after head trauma (odds ratio: 5.8, 95% confidence interval: 1.8-18.9). Additionally, a higher proportion of workers with self-perceived worsening of sleep were diagnosed with depression than those without worsening of sleep (p < 0.05). Conclusions: Preliminary results showed that self-perceived worsening of sleep after head trauma was strongly associated with brain injury. A diagnosis of depression, using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, was significantly related to sleep quality. Hence, investigating sleep problems after head injury hold important implications for the differential diagnosis and treatment.