Evidence map›Paper›PMID 32161046›Full record

Observational studyCMAJ open

Circadian rhythm in the assessment of postconcussion insomnia: a cross-sectional observational study.

Dora M Zalai, Todd A Girard, Michael D Cusimano, Colin M Shapiro

Open access · diamondAbstract readObservational Study
In one paragraph

Observational study in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
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  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Dora M ZalaiDepartment of Psychology (Zalai, Girard), Ryerson University, Toronto, Ont.; Oakville Centre for Cognitive Therapy (Zalai), Oakville, Ont.; Division of Neurosurgery and Injury Prevention (Cusimano), St. Michael's Hospital, University of Toronto; Department of Psychiatry (Shapiro), University of Toronto; Youthdale Child and Adolescent Sleep Centre (Shapiro), Toronto, Ont. drzalai@sleep-psychology.ca.
Todd A GirardDepartment of Psychology (Zalai, Girard), Ryerson University, Toronto, Ont.; Oakville Centre for Cognitive Therapy (Zalai), Oakville, Ont.; Division of Neurosurgery and Injury Prevention (Cusimano), St. Michael's Hospital, University of Toronto; Department of Psychiatry (Shapiro), University of Toronto; Youthdale Child and Adolescent Sleep Centre (Shapiro), Toronto, Ont.
Michael D CusimanoDepartment of Psychology (Zalai, Girard), Ryerson University, Toronto, Ont.; Oakville Centre for Cognitive Therapy (Zalai), Oakville, Ont.; Division of Neurosurgery and Injury Prevention (Cusimano), St. Michael's Hospital, University of Toronto; Department of Psychiatry (Shapiro), University of Toronto; Youthdale Child and Adolescent Sleep Centre (Shapiro), Toronto, Ont.
Colin M ShapiroDepartment of Psychology (Zalai, Girard), Ryerson University, Toronto, Ont.; Oakville Centre for Cognitive Therapy (Zalai), Oakville, Ont.; Division of Neurosurgery and Injury Prevention (Cusimano), St. Michael's Hospital, University of Toronto; Department of Psychiatry (Shapiro), University of Toronto; Youthdale Child and Adolescent Sleep Centre (Shapiro), Toronto, Ont.
University of Toronto · CA

Funding

CIHR TIR-103946
6 · The paper itself

Abstract

backgroundInsomnia is a major predictor of adverse outcomes in mild traumatic brain injury (mTBI), including concussion; although insomnia symptoms may be due to various sleep disorders, those related to circadian rhythm sleep-wake disorders (CRSWDs) require specific assessment and treatment. The objective of the current study was to determine the prevalence of CRSWD in a sample of treatment-seeking people with chronic insomnia symptoms after an mTBI.

methodsParticipants aged 17-65 years who had experienced an mTBI and reported chronic insomnia were recruited from diverse community clinics in Ontario 3-24 months after their injury to participate in this cross-sectional observational study. Potential participants were screened by both telephone and intake interview. Exclusion criteria were alcohol or substance use disorders, preexisting brain disorder or previous neurosurgery, recent travel across more than 2 time zones or shift work. Assessments included a clinical interview, questionnaires, 2 weeks of actigraphy and a sleep diary, and a dim-light melatonin onset test. The main outcome measure was the proportion of patients with CRSWDs.

resultsOf the 50 participants (32 [64%] female; median age 39.5 yr), 13 (26% [standard deviation 12%]) had an CRSWD. The most common circadian diagnosis was delayed sleep-wake phase disorder (10 participants [20%]).

interpretationThe prevalence of CRSWDs may be exceptionally high among people with chronic insomnia symptoms following mTBI. Proper detection and treatment of CRSWDs in this population is essential to facilitate recovery. The findings emphasize the relevance of a diagnostic circadian assessment in patients with mTBI presenting with chronic insomnia symptoms.

Indexed as

Circadian RhythmAdolescentAdultAgedBrain ConcussionCross-Sectional StudiesFemaleHumansMaleMiddle AgedRisk AssessmentRisk FactorsSleep Disorders, Circadian RhythmSleep Initiation and Maintenance DisordersSurveys and QuestionnairesYoung Adult

Identifiers

PMID32161046
PMCPMC7065561
OpenAlexW3011488992

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.