Category: Brain Injury; Military and Veterans Affairs
Objective : To examine the relationship between sleep apnea and telephone-assessed neuropsychological functioning after traumatic brain injury (TBI). We hypothesized that longer duration of sleep apnea would predict poorer performance on telephone-assessed neuropsychological test.
Design : Longitudinal cohort study.
Setting : VA Polytrauma Rehabilitation Center.
Participants (or Animals, Specimens, Cadavers) : Veterans and Military Personnel discharged from inpatient neurorehabilitation, who were enrolled in the VA TBIMS study, with a 2- or 5-year post-TBI follow up including neuropsychological testing (N=55) which was recently added to follow up data collection. Participants were mostly male (96%), White (87%), mean age = 38 (SD=12). TBI severity was 35% severe, 9% moderate, and 56% mild, and 50% of participants had abnormal neuroimaging. Injury mechanism was largely vehicular-related (39%).
Interventions : Not applicable.
Main Outcome Measure(s) : Brief Cognitive Test of Adult Cognition (BTACT)
Results : At the time of assessment, 42% of participants reported having a diagnosis of sleep apnea for an average of .84 years (SD=1.79). The regression model was significant (F(4,45)=6.497, pβ=-.057, p=.671) after adjusting for age, education, and TBI severity. A separate regression model examining the impact of the duration of illness was significant (F(4,43)=5.436, p=.001), but there was not statistically significant relationship between duration of sleep apnea and BTACT composite score (β=-.020, p=.879) after adjusting for other predictors.
Conclusions : Results do not support a relationship between sleep apnea and cognition after TBI, which contrasts prior studies examining the association between cognitive functioning and sleep apnea after TBI (Wilde, 2007). Our study may have been underpowered, and should be replicated with a larger sample. Also, sleep apnea status and duration of illness was determined by self-report and more sensitive measures may be needed. In addition, a prior study has found some reversibility in cognitive deficits following treatment of sleep apnea (Engleman, 2000), however treatment was not analyzed in this study which may have influenced findings.
Erin Brennan– Research Assistant, James A. Haley VA, Tampa, Florida
Emily Noyes– Research Assistant, James A Haley VA Hospital, Tampa, Florida
Amanda Royer– Research Coordinator, James A Haley VA Hospital, Tampa, Florida
Risa Nakase-Richardson– Neuropsychologist, Associate Professor, James A. Haley Veterans' Hospital / University of South Florida, Tampa, Florida
Marc Silva– Neuropsychologist, James A Haley VA Hospital, Tampa, Florida