Evidence map›Paper›PMID 33658328›Full record

ArticleNeurology2021

Traumatic Brain Injury and Incidence Risk of Sleep Disorders in Nearly 200,000 US Veterans.

Yue Leng, Amy L Byers, Deborah E Barnes, Carrie B Peltz, Yixia Li, Kristine Yaffe

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07288593 (Insomnia, Nightmares, and Sympathetic Hyperactivity Intervention in the warfiGHTer), which is not on this map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
4.1field-weighted citation impact, top 5% 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.

NCT07288593 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Insomnia, Nightmares, and Sympathetic Hyperactivity Intervention in the warfiGHTer (INSIGHT)

TypeinterventionalSponsorUniformed Services University of the Health SciencesRan2026 to 2027Enrolled180ConditionsNightmare, Insomnia, PTSD, TBIArmsNightWare smartwatch configured to detect physiological signs of sympathetic activation during sleep, such as heart-rate spikes and movement patterns., Sham (No Treatment)
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 58 citations in OpenAlex.

  1. Article
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  8. Factors influencing shared decision-making for insomnia and obstructive sleep apnea treatment among Veterans with mild traumatic brain injury.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
    Article
  9. Review
  10. Review
  11. Review
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  13. Economic Burden of Trauma-Related Injuries in Iran in 2019.Bulletin of emergency and trauma · 2024
    Article
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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

6 authors at 1 institution in 1 country.

Yue LengFrom the Department of Psychiatry (Y. Leng, A.L.B., D.E.B., K.Y.), Department of Epidemiology and Biostatistics (A.L.B., D.E.B., K.Y.), and Department of Neurology (K.Y.), University of California, San Francisco; and San Francisco Veterans Affairs Health Care System (A.L.B., D.E.B., C.B.P., Y. Li., K.Y.), CA. yue.leng@ucsf.edu kristine.yaffe@ucsf.edu.
Amy L ByersFrom the Department of Psychiatry (Y. Leng, A.L.B., D.E.B., K.Y.), Department of Epidemiology and Biostatistics (A.L.B., D.E.B., K.Y.), and Department of Neurology (K.Y.), University of California, San Francisco; and San Francisco Veterans Affairs Health Care System (A.L.B., D.E.B., C.B.P., Y. Li., K.Y.), CA.
Deborah E BarnesFrom the Department of Psychiatry (Y. Leng, A.L.B., D.E.B., K.Y.), Department of Epidemiology and Biostatistics (A.L.B., D.E.B., K.Y.), and Department of Neurology (K.Y.), University of California, San Francisco; and San Francisco Veterans Affairs Health Care System (A.L.B., D.E.B., C.B.P., Y. Li., K.Y.), CA.
Carrie B PeltzFrom the Department of Psychiatry (Y. Leng, A.L.B., D.E.B., K.Y.), Department of Epidemiology and Biostatistics (A.L.B., D.E.B., K.Y.), and Department of Neurology (K.Y.), University of California, San Francisco; and San Francisco Veterans Affairs Health Care System (A.L.B., D.E.B., C.B.P., Y. Li., K.Y.), CA.
Yixia LiFrom the Department of Psychiatry (Y. Leng, A.L.B., D.E.B., K.Y.), Department of Epidemiology and Biostatistics (A.L.B., D.E.B., K.Y.), and Department of Neurology (K.Y.), University of California, San Francisco; and San Francisco Veterans Affairs Health Care System (A.L.B., D.E.B., C.B.P., Y. Li., K.Y.), CA.
Kristine YaffeFrom the Department of Psychiatry (Y. Leng, A.L.B., D.E.B., K.Y.), Department of Epidemiology and Biostatistics (A.L.B., D.E.B., K.Y.), and Department of Neurology (K.Y.), University of California, San Francisco; and San Francisco Veterans Affairs Health Care System (A.L.B., D.E.B., C.B.P., Y. Li., K.Y.), CA. yue.leng@ucsf.edu kristine.yaffe@ucsf.edu.
University of California, San Francisco · US

Funding

Predictors & Outcomes of Cognitive Trajectories in the Oldest OldK24AG031155 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI YAFFE, KRISTINE · 2007 to 2020
$1.5M
Napping, Sleep, Cognitive Decline and Risk of Alzheimer's DiseaseR00AG056598 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LENG, YUE · 2020 to 2022
$746k
Napping, Sleep, Cognitive Decline and Risk of Alzheimer's DiseaseK99AG056598 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LENG, YUE · 2017 to 2018
$271k
NIA NIH HHS K24 AG031155NIA NIH HHS K99 AG056598NIA NIH HHS R00 AG056598
6 · The paper itself

Abstract

objectiveTo test the hypothesis that veterans with traumatic brain injury (TBI) have an increased subsequent risk of sleep disorders, we studied the longitudinal association between TBI and incident sleep disorders in nearly 200,000 veterans.

methodsWe performed a cohort study of all patients diagnosed with a TBI in the Veterans Health Administration system from October 1, 2001, to September 30, 2015, who were age-matched 1:1 to veterans without TBI. Veterans with prevalent sleep disorders at baseline were excluded. Development of sleep disorders was defined as any inpatient or outpatient diagnosis of sleep apnea, hypersomnia, insomnia, or sleep-related movement disorders based on ICD-9 codes after the first TBI diagnosis or the random selection date for those without TBI. We restricted the analysis to those with at least 1 year of follow-up. We used Cox proportional hazards models to examine the association between TBI and subsequent risk of sleep disorders.

resultsThe study included 98,709 veterans with TBI and 98,709 age-matched veterans without TBI (age 49 ± 20 years). After an average follow-up of 5 (1-14) years, 23,127 (19.6%) veterans developed sleep disorders. After adjustment for demographics, education, income, and medical and psychiatric conditions, those who had TBI compared to those without TBI were 41% more likely to develop any sleep disorders (hazard ratio 1.41 [95% confidence interval 1.37-1.44]), including sleep apnea (1.28 [1.24-1.32]), insomnia (1.50 [1.45-1.55]), hypersomnia (1.50 [1.39-1.61]), and sleep-related movement disorders (1.33 [1.16-1.52]). The association was stronger for mild TBIs, did not differ appreciably by presence of posttraumatic stress disorder, and remained after a 2-year time lag.

conclusionIn 197,418 veterans without sleep disorders, those with diagnosed TBI had an increased risk of incident sleep disorders over 14 years. Improved prevention and long-term management strategies for sleep are needed for veterans with TBI.

Indexed as

AdultAgedBrain ConcussionBrain Injuries, TraumaticCohort StudiesDisorders of Excessive SomnolenceFemaleHumansIncidenceLongitudinal StudiesMaleMiddle AgedParasomniasProportional Hazards ModelsRisk FactorsSleep Apnea Syndromes

Identifiers

PMID33658328
PMCPMC8055309
OpenAlexW3135154896

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.