Sleep Care

Sleep Apnea and Traumatic Brain Injury

Recently in sports, especially in contact sports, the issue of concussions and their long term effects on individuals is a very hot button topic. With more research, more information has surfaced and has begun to lay the foundation of just how dangerous numerous concussions can be to the brain and brain function. While trying to get to the bottom of this dangerous issue there are researchers who believe other factors may actually intensify the risk and damage done from concussions; the risks at the top of the list being OSA (obstructive sleep apnea) and sleep disturbances in general. seau_chargers_ll_120503_wgChronic traumatic encephalopathy is a degenerative neurologic process linked to reoccurring concussions (or acute traumatic brain injury). The rate this process occurs varies from individual to individual and can begin anywhere from a month, to a year, to even a decade after the last know brain trauma. The brain degeneration caused by CTE can lead to depression, memory loss, muscle twitching, memory and concentration issues, and even potential death. Extremely unfortunate situations such as the suicide of Junior Seau (Pro-Bowl linebacker in the National Football League) having an assumed link to CTE has brought to light the importance of education and knowledge regarding CTE. While there is a relation between CTE and concussions/traumatic brain injury it is important to explore other risk factors as well. This begs the question, could sleep apnea and common sleep disturbances in general expedite the degeneration to the brain caused by CTE? A study led by Arunima Verma, Vivek Anand, Narayan Verma, M.D., and another with extensive research taken from 3 academic medical centers (Memorial Hermann Hospital, Transitional Learning Center, and Philadelphia Veterans Administration Medical Center) are just a few of the recent studies that have dove into this topic. The occurrence of insomnia and obstructive sleep apnea has been reported as being as high as 25% in the group of people who have suffered from an acute traumatic brain injury. With OSA and insomnia having the ability to affect memory, concentration, mood and even depression it only makes sense that in the group suffering from both traumatic brain injury and a sleep disturbance cognitive function has been found to be poorer than in individuals who have just suffered from TBI alone. Recently there has also been a link identified in patients with dementia and some sort of sleep disorder.

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Ultimately this information leads to the question, could OSA or insomnia actually increase risk and or severity of CTE in patients who have experienced traumatic brain injuries? Could OSA and or insomnia make the effects of CTE more severe and the progression more aggressive? It certainly looks that way. While more research is being done there are steps being taken in the right direction to be proactive in the battle against CTE. College and professional sports are changing rules, making certain plays or hits illegal, and instituting fines and penalties for those actions that cause more concussions in athletes. More programs are being made available for proper education for youth sports as well involving not only coaches but training staff as well. Early detection and awareness is absolute key and the NFL has teamed up with the National Institutes of Health to fund for further research on the topic.

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