A systematic review and meta-analysis of sleep following mild traumatic brain injury: A synthesis of the literature according to age and time-since-injury
Abstract
This systematic review and meta-analysis (PROSPERO: CRD42021287081) compared sleep in individuals with prior mTBI against that of controls. PubMed, Scopus, and EMBASE were searched through to November 2, 2024. Mean differences were calculated for objective (sleep duration, sleep efficiency, sleep stage [N1-3, REM] proportions) and subjective (Pittsburgh Sleep Quality Index [PSQI]) sleep measures, with analyses conducted based on age (adult ≥18y; child <18y) and time-since-injury/recovery phase (<1w, <1m, 1-12m, ≥1y). Qualitative syntheses were also conducted according to age and recovery phase. Sixty-nine studies met criteria. In children and adults, mean differences in objective sleep duration and sleep efficiency were not statistically significant for any recovery phase. Relative to controls, adults with mTBI had proportionately more N1 (Mean diff. [95%CI], 1.28 % [0.63 %,1.93 %], p = 0.014) and less N3 (-1.16 % [-2.08 %,-0.23 %], p = 0.033) sleep at 1-12-month follow-up, and less REM (-3.37 % [-6.28 %,-0.46 %], p = 0.023) at ≥1 year follow-up; however, these statistical differences did not remain when studies confounded by selection bias were removed. Subjectively, relative to controls, adults with mTBI had higher PSQI scores at <1-week (2.53 [1.43,3.62] points, p = 0.005), <1-month (2.26 [1.47, 3.04], p < 0.001), 1-12-month (2.86 [1.26,4.45], p < 0.001) and ≥1-year (2.62 [1.96, 3.28], p < 0.001) follow-up. The literature suggests individuals with prior mTBI have poorer…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.