Abstract Introduction Traumatic brain injury (TBI) is a prevalent and serious injury among older adults, often resulting in adverse physical, cognitive, and mental health consequences. Insufficient sleep and poor quality sleep are also common following TBI and can negatively impact many of these same sequalae. The purpose of this study was to test the hypotheses that sleep duration and sleep quality at two weeks following TBI are associated with anxiety symptoms at three months following TBI among older adults with mild TBI. Methods Adults aged 65 and older treated for TBI within 72 hours of injury at trauma centers, emergency departments, and hospitals who provided informed consent were included. Subjective sleep was assessed via a standardized self-report sleep diary completed daily for one consecutive week, beginning two weeks following TBI. Sleep duration was defined as mean total sleep time, and sleep quality was defined as mean ratings from a ten-point rating scale (10=highest). Anxiety symptoms were assessed via the Hospital Anxiety and Depression Scale, administered three months post injury. Ordinal regression models examined the associations between sleep duration and sleep quality at two weeks following TBI and subsequent anxiety three months following TBI, controlling for age and sex. Results Participants included 108 older adults (mean age = 76.3 years, SD = 7.4). Ordinal regression analyses revealed no statistically significant association between sleep duration and anxiety (OR = 0.88; 95% CI: 0.70–1.11). However, sleep quality was significantly associated with anxiety symptoms, such that better sleep quality at two weeks was associated with lower odds of anxiety at three months following TBI (OR = 0.68; 95% CI: 0.52–0.89). Conclusion Sleep quality, but not sleep duration, is associated with anxiety among older adults with TBI. Future studies should employ multimethod assessment of sleep, including subjective and objective measures, among older adults with TBI. Interventions targeting sleep quality could be important for improving mental health outcomes in this population. Support (if any) R01AG076441 (National Institute of Aging) (PI: JSA)
Masino et al. (Fri,) studied this question.