Disrupted sleep predicts next day agitation following moderate to severe brain injury

Christina Draganich, Don Gerber, Kimberley R. Monden, Jody Newman, Alan Weintraub, Jennifer Biggs, Angela Philippus, Michael Makley

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective: Disrupted sleep is common during acute recovery from traumatic brain injury (TBI) and has been linked to daytime agitation. This study investigated the relationship among nighttime sleep efficiency (SE), total sleep time (TST), wakefulness after sleep onset (WASO), and number of wake bouts (NWB) as measured by actigraphy to observer ratings of agitation for patients with TBI who were undergoing inpatient rehabilitation. Methods: This is a retrospective, observational study of a convenience sample of 65 individuals admitted to TBI inpatient rehabilitation who were monitored with actigraphy and the Agitated Behaviour Scale (ABS) for the first 72 h. Each patient’s average SE, TST, WASO, and NWB for the 72-h period was calculated using actigraphy for the rest interval from 2100 to 0700. Daily ABS scores were obtained for each day following the nighttime sleep period. Results: Patients were not significantly different on age, gender, etiology of injury, days post-injury, rehabilitation length of stay, or severity of injury as measured by length of posttraumatic amnesia (PTA). SE and TST were significantly lower for patients with agitation than for patients without agitation. Conclusions: This study suggests a relationship between disrupted sleep and agitation for patients with TBI who are undergoing inpatient rehabilitation.

Original languageEnglish (US)
Pages (from-to)1194-1199
Number of pages6
JournalBrain Injury
Issue number9
StatePublished - Jul 29 2019

Bibliographical note

Funding Information:
The authors report no conflict of interest. This work was supported by the Craig Hospital Foundation and MINDSOURCE – Brain Injury Network, formerly the Colorado Brain Injury Trust Program, under grant number NCT02838082.

Publisher Copyright:
© 2019, © 2019 Taylor & Francis Group, LLC.


  • Brain injury
  • actigraphy
  • agitation
  • sleep


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