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Insomnia is more likely among persons with mild brain injuries or depression

Categories: Depression

The Question

In the post-acute rehabilitation phase of recovery, what contributes to insomnia among people with brain injuries?

Past Studies

Past Studies found that people with milder brain injuries and people with brain injuries who suffered from chronic pain were more likely to develop insomnia.

This Study

This Study included ninety-one people who were admitted to an outpatient brain injury rehabilitation program. People were excluded from the study if they had amnesia, were on sleeping medications or if they had not fully awakened from the coma. Each person was tested for depression, sleep quality, and pain which interfered with sleep. This information was combined with information from medical records. The study found that a person’s age, gender, and education did not predict insomnia. However, people with milder injuries or depression were more likely to experience insomnia. “…68% of the depressed subjects suffered from insomnia and 81% of the insomniacs were depressed.” Pain by itself did not predict who would have insomnia.

Who May Be Affected By This Study

People with mild brain injuries, especially those who are depressed.


Since insomnia is a common feature of depression, future studies need to determine if depression in TBI causes an even greater likelihood of insomnia. Further, the study does not identify the actual number of persons in the study who did and did not have insomnia. The connection between mild brain injury and insomnia needs to be studied further to determine whether other factors may be contributing to insomnia.

Bottom Line

In the early phases of recovery from a brain injury, insomnia may be the result of physiologic changes while in the post-acute rehabilitation phase, it may be the result of psychological and social factors. This is important in determining the right treatment. People with mild brain injuries who are depressed should be assessed and treated for insomnia because lack of sleep can interfere with rehabilitation.

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Find This Study

Fichtenberg, Norman R.; Millis, Scott R.; Mann, Nancy R.; Zafonte, Ross D.; and Millard, Anna E. “Factors associated with insomnia among post-acute traumatic brain injury survivors”, Brain Injury; 2000:14, 659-667.