PTOTSLPCohortThe Journal of head trauma rehabilitation2025

Course of Fatigue and Sleep After Moderate to Severe Traumatic Brain Injury.

Jessica Bruijel, Sven Stapert, Annemiek Vermeeren and 3 others

PMID 40705988

WHAT IT FOUND

Fatigue and poor sleep remained high and stable for 18 months after moderate to severe brain injury.

Physical tiredness and objectively measured sleep time decreased slightly. Mood problems consistently linked to worse fatigue and sleep quality, while processing speed did not.

Key findings

01General fatigue and poor subjective sleep quality remained stable and clinically significant over the 18-month follow-up period.

02Physical fatigue and objectively measured total sleep time decreased significantly over time, but subjective sleep quality did not improve.

03Higher levels of anxiety and depression were consistently associated with worse general, physical, and mental fatigue, as well as poorer subjective sleep quality.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Small sample size (42 participants) limits the ability to detect distinct individual trajectories or fully test the biopsychosocial model. Missing data due to dropouts and COVID-19 restrictions, particularly for processing speed measures. Participants were relatively mild within the moderate-to-severe TBI category based on post-traumatic amnesia and loss of consciousness data. Excluded individuals with pre-existing neurological, psychiatric, or sleep conditions, which may limit generalizability to the broader TBI population. COVID-19 lockdowns may have artificially influenced participation levels and mood during the study period.

The easy way to misread this

Do not conclude that sleep quality improved because total sleep time decreased. Subjective sleep quality remained poor and stable throughout the 18 months, and sleep efficiency actually worsened for many participants.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →