Ch 7: Fatigue & Sleep Disturbance

Question 1

What percent of people with brain injury report fatigue?

Answer 1

32-73%

One of the most common post concussion symptoms across the severity spectrum

Question 2

Fatigue

Answer 2

The awareness of a decreased capacity for physical and/or mental activity due to an imbalance in the availability, utilization, and/or restoration of resources needed to perform activity

Resources may be physiological or psychological

Question 3

Physical fatigue

Answer 3

May be associated with muscle weakness or other changes/injuries in the PNS

Question 4

Physiological fatigue

Answer 4

Depletion of energy, hormones, neurotransmitters, or a reduced number of neuronal connections, 2’ brain injury

Question 5

Primary fatigue

Answer 5

Directly from injury or disease

Question 6

Secondary fatigue

Answer 6

Relates to factors that may exacerbate fatigue, such as pain, sleep disturbance or stress

Question 7

Fatigue assessments should?

Answer 7

Quantify fatigue levels, assess subjective distress caused by fatigue, and measure the impact of fatigue on performance of daily activities, it’s association with secondary factors such as sleep or depression, and identify biological parameters; Currently no single valid and reliable method of assessing fatigue

Question 8

What are the contributing factors that should be assessed in pts who report fatigue post brain injury?

Answer 8

Attention
Processing speed
Meds
Pain
Mood
Sleep changes

Question 9

Visual Analogue Scale for Fatigue

Answer 9

Quantifies fatigue levels at one point in time

Question 10

Fatigue Severity Scale

Answer 10

assesses behavioral consequence of fatigue

Question 11

Barrow Neurological Institute Fatigue Scale

Answer 11

10 items such as how difficult is it for me to maintain my energy throughout the day, how difficult is it for me to stay alert during activities

Question 12

Global Fatigue Index

Answer 12

self report measure of four domains- severity, distress, impact on activity, timing of fatigue

Question 13

Causes of Fatigue Questionnaire

Answer 13

extent to which a broad range of physical and mental activities cause fatigue

Question 14

What is the coping hypothesis?

Answer 14

fatigue may result from the compensatory effort necessary to meet the everyday demands of life in the presence of cognitive deficits including attention and impaired processing speed

Question 15

What are the causes of sleep disturbance following TBI?

Answer 15

injury to suprachiasmatic nucleas, hypothalamus, midbrain, ascending reticular activating system

Question 16

Non-pharmacological approach to sleep disturbance

Answer 16

sleep hygiene, avoid naps, avoid awake time in bed

Question 17

Pharmacological approach to sleep disturbance

Answer 17

zolpidem and zopiclone for insomnia but not long term;

modafinil is a wake promoting drug for treating excessive sleepiness