Traumatic brain injury (TBI) affects nearly 1.5 million individuals in the United States each year. During peacetime, over 7,000 Americans with a diagnosis of TBI are admitted to military and veterans hospitals every year; this number increases significantly during combat, during which TBI may comprise up to 20% of survivor casualties. Pain and discomfort relating to injuries are frequent causes of sleep disturbance in TBI patients. Sleep disturbances can manifest as difficulty falling or staying asleep, early morning wakening and non-restorative sleep, and affects up to 30% of individuals with TBI. Because there are few studies on pharmacotherapy for sleep disturbances in TBI, many physicians base their intervention on experience with the general population. in this poster, we will consider the unique features of the patient with TBI and make recommendations for psychoactive medications that are appropriate to treat insomnia in this population.

A literature review was performed and recommendations for treatment of sleep disturbances in patients with TBI are summarized here based on published findings.

Non-pharmacological means should be the first-line treatment for sleep disturbances in patients with TBI. These include sleep hygiene and cognitive behavioral therapy. Physicians and other clinicians should pay attention to the specific sleep complaint, adverse effect profile of the medication as well as the anticipated duration of treatment before deciding upon a sleep agent for patients with TBI.