Towards an understanding of disturbed sleep phenotypes after traumatic spinal cord injury.

The study used existing electronic health record diagnosis codes, and the authors said EHRs are primarily designed for billing and coding, which makes research use challenging. Outdated or overlapping spinal cord injury diagnosis codes led to exclusion of about 6,900 people, and the team said hand-sorting these records was not feasible. The report includes hypersomnia in one cluster, then later says hypersomnia was dropped for insufficient data, and the complete-information count is not consistent across the text and tables. The sample was Veterans with traumatic spinal cord injury, mostly male and white, so results may not apply to women, civilians, or other groups. The analysis describes which diagnoses appeared together; it does not show that treating one condition changes another.

The authors declared no conflicts of interest. The work was supported by NIH grant R25 HL105400.

Do not read these clusters as proof that sleep apnoea causes heart and metabolic disease, or that insomnia causes anxiety and post-traumatic stress disorder. The study used existing coded records and did not test treatment.