Relationship among subjective sleep complaints, headaches, and mood alterations following a mild traumatic brain injury.

BACKGROUND

Sleep complaints (e.g., frequent awakenings, nightmares), headaches and mood alterations (e.g., feeling depressed, irritable) can appear following a mild traumatic brain injury (MTBI). The objective of this retrospective study was to assess the relationships between the above symptoms. Our hypothesis was that sleep complaints might be among the risk factors for the development of headaches and mood alterations.

METHODS

The consecutive charts of 443 patients (68.2% males vs. 31.8% female; mean age of 46.9 years) diagnosed with MTBI were reviewed for past medical history and above symptoms using the Rivermead post-concussion symptom assessment questionnaire and self-report. Data were retrieved in 2 time courses: 10 days and 6 weeks.

RESULTS

For the 2 time courses, the prevalence of subjective sleep complaints were 13.3% and 33.5%; headaches 46.8% and 39.3%; feeling depressed 9.5% and 20.4%; and feeling irritable 5.6% and 20.2%, respectively. Reports of sleep complaints at 6 weeks were 2.9 times (p=0.004) more likely if such a symptom was reported at 10 days. Moreover, the presence of sleep complaints at 10 days is associated with concomitant headaches, depressive symptoms, and feeling irritable by 2.3, 9.9, and 12.2 times (p=0.0001 and 0.014); and by 2.9, 6.3, and 4.8 times (p=0.0001) at 6 weeks, respectively.

CONCLUSIONS

Our results suggest that patients afflicted with sleep complaints are more likely to suffer from concomitant headaches, depressive symptoms, and irritability.