• Julia Kempf, Esther Werth, Philippe R Kaiser, Claudio L Bassetti, and Christian R Baumann.
• Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland; christian.baumann@usz.ch.
• J. Neurol. Neurosurg. Psychiatr. 2010 Dec 1;81(12):1402-5.

Background6 months after traumatic brain injury (TBI), almost three out of four patients suffer from sleep-wake disturbances (SWD) such as post-traumatic hypersomnia (increased sleep need of ≥2 h compared with before injury), excessive daytime sleepiness (EDS), fatigue and insomnia. The long-term course of post-traumatic SWD, however, is unknown.ObjectivesTo assess the prevalence and characteristics of post-traumatic SWD 3 years after trauma.DesignProspective longitudinal clinical study in 51 consecutive TBI patients (43 males, eight females, mean age 40±16 years).Main Outcome MeasuresEDS (as assessed by the Epworth sleepiness scale), fatigue (fatigue severity scale), post-traumatic hypersomnia (sleep length per 24 h), insomnia, depression and anxiety.ResultsPost-traumatic SWD were found in 34 patients (67%): post-traumatic hypersomnia in 14 (27%), EDS in six (12%), fatigue in 18 patients (35%) and insomnia in five patients (10%). SWD were not associated with severity or localisation of, or time interval since, TBI. Insomnia was linked to depressive symptoms.ConclusionsThis prospective study shows that 3 years after TBI, two out of three patients suffer from residual SWD, particularly fatigue and post-traumatic hypersomnia. In 45% of TBI patients, SWD appear directly related to the trauma itself.

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