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Title: Sleep disorder following traumatic brain injury : an investigation of the predictors of sleep disorder 12 months or more following traumatic brain injury
Author: Couston, M. C.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2003
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Objective: The purpose was to identify the characteristics predictive of sleep disorder in a sample of traumatic brain injury (TBI) patients, twelve months or more following trauma. Design: A between-subject design explored the relationship between the participant’s sleep disturbance and the severity of TBI. A within-subjects design investigated reliability of the sleep disorder self-report and explored differences between ratings of the participant and a significant other. In addition, qualitative analysis based on content analysis, investigated themes relating to sleep experiences generated by a semi-structured interview. (A) Participants: Eighteen males and 15 significant others were recruited from patients who were admitted to The Scottish Brain Injury Unit (SBIRS) between June 2002 and June 1997. The participants were predominantly in the severe TBI category. Measures: The following were the factors measured, and the instruments used for this purpose: sleep quality (The Pittsburgh Sleep Index; PSQI), psychological distress (Hamilton rating Scale for Depression, HRSD; Hospital Anxiety and Depression Scale, HADS) and fatigue (Bentall fatigue inventory and a Visual Analogue Scale, VAS-F). Significant others completed only the PSQL. (B) Results: Fifty per cent of the sample reported poor sleep quality and 22 per cent of the participants had insomnia. Among the demographic, affective and injury variables examined, the strongest relationship with sleep quality was linked to depression. The significant other ratings were no different to the participant’s self-ratings. Interestingly, sleep quality rather than TBI severity appeared linked to depression.  Conclusions: This sample has reported slightly lower rates of sleep disturbance than a comparable post acute population but this is still more than double the rate of sleep disturbance in the normal population. There was evidence that links may be between poor sleep quality and depression, perhaps even depression secondary to insomnia, rather than TBI. In addition TBI is considered as a model for depression. The importance of evaluating treatments for insomnia in this group is discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available