Methods: This was a cross-sectional study. We conducted the study in a medical center of the northern Taiwan. Sixty older adults (aged > 65 years) with first-ever mild to severe TBI and 60 age- and gender-matched healthy elderly people were included. To assess insomnia, excessive daytime sleepiness, and obstructive sleep apnea, the Athens Insomnia Scale, Epworth Sleepiness Scale, and STOP-bang were used. Quality of life was measured by using the Quality of Life after Brain Injury. Multivariate linear regression model was used for data analyses.
Results: Mean age in older adults with TBI and healthy controls was 73.1 and 72.2 years.In the cases and controls, more than half of participants were males (54% vs. 52%). Older adults with TBI yielded a higher frequency of nocturia and a lower frequency of exercise in comparison with those of health controls (p < 0.001 and 0.001). Average time to injury was 7.06 months. We found that older adults with TBI had higher prevalence of insomnia, excessive daytime sleepiness, and obstructive sleep apnea (45%, 62%, and 78%, respectively) than those of healthy controls (24%, 15%, and 51%, respectively, with all p values < 0.05). Multivariate linear regression model showed that the scores of STOP-Bang and Athens Insomnia Scale significantly and negatively correlated with quality of life after TBI while controlling for potential confounders.
Conclusions: The current evidence suggests that insomnia, excessive daytime sleepiness, and obstructive sleep apnea are common in older adults following TBI. The severity of insomnia and obstructive sleep apnea substantially impact quality of life in elderly people with TBI.