Sleep Wake Cycle Dysfunction Following Traumatic Brain Injury in the Acute Care Setting

Sleep wake cycle dysfunction (SWCD) following traumatic brain injury (TBI) affects at least 50% of survivors and can negatively affect cognition, mood, behaviors, pain, and possibly, neural remodeling that is critical for recovery. It is likely a multifactorial phenomenon and remains poorly understood. SWCD is often documented in the early days to weeks following injury and can have negative effects on patients’ acute care and rehabilitation courses. This chapter aims to describe normal sleep physiology, pathophysiology of sleep dysfunction following TBI, the most common post-traumatic sleep disorders, methods for evaluation in the acute care and inpatient rehabilitation settings, and pharmacological/non-pharmacological interventions based on current literature.