Dataset Information

Trajectories of Insomnia in Adults After Traumatic Brain Injury.

ABSTRACT:

Importance

Insomnia is common after traumatic brain injury (TBI) and contributes to morbidity and long-term sequelae.

Objective

To identify unique trajectories of insomnia in the 12 months after TBI.

Design, setting, and participants

In this prospective cohort study, latent class mixed models (LCMMs) were used to model insomnia trajectories over time and to classify participants into distinct profile groups. Data from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, a longitudinal, multisite, observational study, were uploaded to the Federal Interagency Traumatic Brain Injury Repository (FITBIR) database. Participants were enrolled at 1 of 18 participating level I trauma centers and enrolled within 24 hours of TBI injury. Additional data were obtained directly from the TRACK-TBI investigators that will be uploaded to FITBIR in the future. Data were collected from February 26, 2014, to August 8, 2018, and analyzed from July 1, 2020, to November 15, 2021.

Exposures

Traumatic brain injury.

Main outcomes and measures

Insomnia Severity Index assessed serially at 2 weeks and 3, 6, and 12 months thereafter.

Results

The final sample included 2022 participants (1377 [68.1%] men; mean [SD] age, 40.1 [17.2] years) from the FITBIR database and the TRACK-TBI study. The data were best fit by a 5-class LCMM. Of these participants, 1245 (61.6%) reported persistent mild insomnia symptoms (class 1); 627 (31.0%) initially reported mild insomnia symptoms that resolved over time (class 2); 91 (4.5%) reported persistent severe insomnia symptoms (class 3); 44 (2.2%) initially reported severe insomnia symptoms that resolved by 12 months (class 4); and 15 (0.7%) initially reported no insomnia symptoms but had severe symptoms by 12 months (class 5). In a multinomial logistic regression model, several factors significantly associated with insomnia trajectory class membership were identified, including female sex (odds ratio [OR], 1.65 [95% CI, 1.02-2.66]), Black race (OR, 2.36 [95% CI, 1.39-4.01]), history of psychiatric illness (OR, 2.21 [95% CI, 1.35-3.60]), and findings consistent with intracranial injury on computed tomography (OR, 0.36 [95% CI, 0.20-0.65]) when comparing class 3 with class 1.

Conclusions and relevance

These results suggest important heterogeneity in the course of insomnia after TBI in adults. More work is needed to identify outcomes associated with these insomnia trajectory class subgroups and to identify optimal subgroup-specific treatment approaches.

SUBMITTER: Wickwire EM

PROVIDER: S-EPMC8792888 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Trajectories of Insomnia in Adults After Traumatic Brain Injury.

Wickwire Emerson M EM Albrecht Jennifer S JS Capaldi Vincent F VF Jain Sonia O SO Gardner Raquel C RC Werner J Kent JK Mukherjee Pratik P McKeon Ashlee B AB Smith Michael T MT Giacino Joseph T JT Nelson Lindsay D LD Williams Scott G SG Collen Jacob J Sun Xiaoying X Schnyer David M DM Markowitz Amy J AJ Manley Geoffrey T GT Krystal Andrew D AD

JAMA network open 20220104 1

<h4>Importance</h4>Insomnia is common after traumatic brain injury (TBI) and contributes to morbidity and long-term sequelae.<h4>Objective</h4>To identify unique trajectories of insomnia in the 12 months after TBI.<h4>Design, setting, and participants</h4>In this prospective cohort study, latent class mixed models (LCMMs) were used to model insomnia trajectories over time and to classify participants into distinct profile groups. Data from the Transforming Research and Clinical Knowledge in Trau ...[more]

PMID: 35080600

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Dataset Information

Trajectories of Insomnia in Adults After Traumatic Brain Injury.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Trajectories of Insomnia in Adults After Traumatic Brain Injury.

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