Sleep apnea in adults with traumatic brain injury: a preliminary investigation.

OBJECTIVE

To determine the occurrence and nature of sleep-related breathing disorders in adults with traumatic brain injury (TBI).

DESIGN

Prospective, observational, consecutive sample enrollment of subjects admitted for rehabilitation after TBI.

SETTING

Inpatient rehabilitation and subacute rehabilitation units of a tertiary care university medical system.

PARTICIPANTS

Subjects (n = 28) included adults with TBI and a Rancho Los Amigos Scale level of 3 or greater who were less than 3 months postinjury and admitted for comprehensive inpatient rehabilitation.

INTERVENTIONS: Overnight sleep study using portable 6-channel monitoring system.

MAIN OUTCOME MEASURE: Respiratory disturbance index (RDI), which is the number of apneic and hypopneic episodes per hour of sleep.

RESULTS

Evidence of sleep apnea was found in 10 of 28 (36%) subjects as measured by a RDI level of 5 or greater and in 3 of 28 (11%) subjects as measured by a RDI level of 10 or greater. This rate of sleep apnea is significantly (p =.002) higher than would be predicted based on population norms. No correlation was found between the occurrence of significant sleep apnea and measures of TBI severity or other demographic variables. Sleep-related breathing disorders were primarily central though obstructive apneas were also noted.

CONCLUSION

In this preliminary investigation, sleep-related breathing disorders as defined by a respiratory disturbance index of 5 or greater appears to be common in adult subjects with TBI.