Effects of Blast- and Impact-Related Concussion on Persistent Sleep Problems.
Samuel Y Chung, Elizabeth M Harrison, Robyn M Englert and 1 others
PMID 38916404WHAT IT FOUND
Marines who had blast-related concussion were more likely to report sleep problems six months after deployment than Marines who did not.
Impact-related concussion also raised that likelihood. Sleep trouble at return was the strongest reported link.
Key findings
01Blast-related concussion and impact-related concussion were associated with higher adjusted odds of sleep problems (adjusted odds ratio 2.57 and 1.67).
02Sleep problems at return from deployment had the highest adjusted odds ratio in the model, followed by blast-related concussion.
03Blast-related concussion had significant interactions with PTSD and depression in the model.
STILL TO COME
How it was doneWhat they found
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What it does not show
Sleep problems were measured with self-report items about sleeping trouble or still feeling tired, not with diagnosed insomnia, sleep apnea, or sleep severity. Concussion, PTSD, depression, and alcohol misuse were screening classifications, not clinical diagnoses. Data were retrospective and self-reported, with possible recall bias and pressure to underreport symptoms. Missing data were substantial before imputation: alcohol misuse 51.85%, depression 37.91%, sleep problems at return 24.08%, and PTSD 4.04%. The analysis used 64 464 of 102 075 matched records, so many records were excluded. The study could not control for blast proximity, intensity, or type, nor for pre-deployment sleep problems or diagnosed sleep disorders. The sample was 95.68% male, so sex-related findings are limited.
Declared interests
No conflicts of interest were declared. The research was funded by the US Army Medical Research and Material Command under Work Unit No. N1518.
The easy way to misread this
Do not conclude that blast-related concussion causes persistent sleep problems or that any single factor explains them. The study used self-report screening items, not clinical diagnoses, and several factors, including prior sleep problems, PTSD, depression, alcohol misuse, and blast exposure, were modeled together.