Article

Traumatic brain injury is a leading cause of death and disability in both Canada and the United States. Disorders of sleep and wakefulness are among the most commonly reported sequelae postinjury, across all levels of severity. Despite this, sleep and wakefulness are neither routinely, nor systematically, assessed and are only recently beginning to receive more clinical and scientific attention. Objectives: This review aims to systematically appraise the literature regarding sleep and wake disorders associated with traumatic brain injury according to the following domains: epidemiology, pathophysiology, neuropsychological implications, and intervention; to summarize the best evidence with a goal of knowledge translation to clinical practice; and to provide recommendations as to how the field can best be advanced in the most scientifically rigorous manner. Methods: Systematic review and rating of the quality of evidence. Results: Forty-three articles were reviewed for levels and quality of evidence. Fifty-six percent of the literature was classified as Level III, and 24 percent were Level IVA. Overall, 89 percent of the studies were rated as moderate quality. A separate summary was provided for the pediatric literature. Conclusions: A comprehensive review of the emerging literature revealed wide ranges in estimates for incidence and prevalence of sleep disorders following TBI depending on characteristics of patients, measures used, and length of follow-up. Few treatments have been found to be effective, and as such more research is recommended. Our overview of the pediatric literature shows that this is an important issue for survivors of all ages. Overall, further work is needed to fully understand this complex disorder and to identify appropriate and timely interventions.

Langue : ANGLAIS