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Brain Injury Patients Plagued by Poor Sleep, Depression

Study suggests disrupted circadian rhythm results in lower melatonin, more psychological stress

TUESDAY, May 25 (HealthDay News) --Patients with traumatic brain injury exhibit disrupted circadian rhythms and lower levels of melatonin production, contributing to poor sleep quality, anxiety and depression, according to a study in the May 25 issue of Neurology.

Julia A. Shekleton, of Monash University in Clayton, Australia, and colleagues studied 23 TBI patients (14 months after their injury, on average) and 23 age- and gender-matched healthy controls to assess changes to sleep associated with TBI. The researchers compared the cohorts on a series of polysomnographic measures; salivary dim light melatonin onset (DLMO) time; and subject-reported sleep quality, anxiety and depression.

The researchers found that the TBI patients had higher scores on the Pittsburgh Sleep Quality Index than the healthy subjects, indicating disrupted sleep patterns. They also subjectively reported more sleep disturbances and higher levels of depression and anxiety compared to controls. While salivary DMLO time did not differ for the TBI and healthy subjects, the TBI subjects exhibited significantly lower evening melatonin production than the healthy subjects.

"Patients with TBI showed lower levels of melatonin production in the evening hours, indicating that the circadian regulation of melatonin synthesis was disrupted. Elevated levels of psychological distress, particularly depression, were found to be associated with reduced sleep quality," the authors write.

One author reported being on editorial boards for journals on TBI topics, receiving royalties for books on TBI, and serving as a consultant or expert witnesses in legal cases involving TBI; another author disclosed financial ties to pharmaceutical companies. Compumedics Pty Ltd., Australia, provided the polysomnography equipment used in the study.

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