Sleep before and after work-related concussion: Sex differences in effects and functional outcomes

Article type: Research Article

Authors: Mollayeva, Tatyana^{a; b; c; d; j; *} | Sharma, Bhanu^b | Vernich, Lee^d | Mantis, Steve^e | Lewko, John^f | Gibson, Brian^g | Liss, Gary^h | Kontos, Pia^{b; i} | Grigorovich, Alisa^{b; i} | Colantonio, Angela^{a; b; c; d; j}

Affiliations: [a] Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada | [b] KITE Toronto Rehabilitation Institute University Health Network, Toronto Rehabilitation Institute University Health Network, Toronto, Canada | [c] Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada | [d] Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada | [e] Ontario Network of Injured Workers Groups, Research Action Committee, Toronto, Canada | [f] School of Rural and Northern Health, Laurentian University, Sudbury, Canada | [g] Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada | [h] Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada | [i] Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada | [j] Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

Correspondence: [*] Address for correspondence: Tatyana Mollayeva, MD, PhD., KITE Toronto Rehabilitation Institute University Health Network, Toronto Rehabilitation Institute University Health Network, 550 University Avenue, Rm 11183, Toronto, Ontario M5G 2A2, Canada. Tel: +1 416 597 3422/Ext 7848; E-mail: [email protected].

Abstract: BACKGROUND:Recent studies have started disentangling components of disturbed sleep as part of the post-concussive syndrome, but little is known about the workers with an injury’ perspectives on post-injury sleep changes or what causes these changes. OBJECTIVES:To determine the effects of work-related concussion/mild traumatic brain injury (wr-mTBI) on perceptions of refreshing sleep in workers with an injury and to identify the relevant factors responsible for sleep changes. METHODS:We studied post-concussive changes in sleep in 66 adults (50% male workers, 42% aged 30–50 years, median post-injury days: 155) who had sustained wr-mTBI and experienced functional limitations long after the injury. We collected sociodemographic, occupational and health status data and identified variables related to post-concussive changes in refreshing sleep. RESULTS:Forty-seven workers with wr-mTBI (79% of male workers, 64% of female workers) perceived their sleep as being refreshing before injury and unrefreshing afterwards (χ2 = 67.70 for change, χ2 = 27.6 for female and χ2 = 41.1 for male workers, p < 0.0001). Post-concussive losses in refreshing sleep were associated with socio demographic, occupational, and health status data variables. Sex stratification revealed differences between male and female workers. CONCLUSIONS:Workers with wr-mTBI experience clinically meaningful changes in refreshing sleep that are associated with modifiable variables. The observed differences in functional outcomes between male and female workers warrant further study.

Keywords: Fatigue, Global Assessment of Functioning, insomnia, mild traumatic brain injury, occupational injury

DOI: 10.3233/WOR-203343

Journal: Work, vol. 67, no. 4, pp. 927-938, 2020