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Volume 46 Number 6, 2009
   Pages 827 — 836

Abstract —  Insomnia in the context of traumatic brain injury

Jamie M. Zeitzer, PhD;* Leah Friedman, PhD; Ruth O'Hara, PhD

Psychiatry Service, Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA

Abstract —  Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality in the United States. One of the most common comorbidities of TBI is the disruption of normal sleep. While often viewed as a nuisance symptom, sleep disruption can delay TBI recovery and negatively affect many of the psychological (e.g., anxiety, depression) and neuromuscular (e.g., pain) sequelae of TBI, decreasing quality of life. Treatment of sleep disruption in the context of TBI is complicated by issues of an altered neuronal milieu, polypharmacy, and the complex relationship between the various comorbidities often found in patients with TBI. Given the growing number of veterans returning from combat with TBI and the elevated risk of comorbid disrupted sleep, both caused by and independent of TBI, a comprehensive review of sleep disruption and its treatment is of great relevance to the Department of Veterans Affairs.

Key words: cognitive behavioral therapy, comorbidity, insomnia, pharmacotherapy, rehabilitation, sleep, sleep disorder, sleep disruption, traumatic brain injury, veterans.

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