Key Points

  • Fatigue symptoms appear to be increased in individuals who sustain an ABI.
     
  • Higher levels of fatigue lead to a poorer quality of life.
     
  • Fatigue and sleep disturbances impact individuals physically, cognitively, and psychologically.
     
  • Individuals with fatigue and sleep disturbances may have increased levels of anxiety and depression.
     
  • Those with fatigue, compared to those without, were shown to have lower level jobs and more nonpaying jobs.
     
  • Fatigue related quality of life is associated with somatic symptoms of TBI and situational stress.
     
  • Fatigue experienced post-TBI has been linked to a decrease in vigilance.
  • Within TBI population, the relationship between vigilance and fatigue is affected and confounded by depression, anxiety, and sleep disturbances.
     
  • The effects of pacing strategies for those who have sustained an ABI are not known.
     
  • Cognitive behavioural therapy has been shown to be effective in treating insomnia related to TBI. Additional research in this area is warranted.
     
  • Acupuncture therapy has been shown to improve perception of sleep and sleep quality; however due to the small sample further research is needed.
     
  • Blue light therapy was found to reduce fatigue and daytime sleepiness; however the improvements did not persist beyond the treatment period.
     
  • Modafinil has not been shown to be effective in treating fatigue.
     
  • Modafinil has been shown to be effective short-term in treating excessive daytime sleepiness, but may also cause insomnia. 
     
  • Methylphenidate does not have an adverse effect on the sleep-wake cycle of those who have sustained a TBI when given in commonly accepted dosages.