Older injured adults reported sleep disturbances: a cross-sectional study

TL;DR

This study found that sleep problems are common in older adults recovering from injury and are linked to mental health and pain issues.

Contribution

The study is novel in using PROMIS-based assessments early after injury to identify modifiable factors in older trauma survivors.

Findings

About 22% of older trauma patients reported sleep disturbances.

PTSD and pain symptoms were strongly associated with sleep disturbances.

The study highlights the importance of early, patient-centered interventions for sleep issues in trauma recovery.

Abstract

Sleep disturbances are common among older adults recovering from traumatic injury and are associated with delayed psychological and functional recovery. Despite their prevalence, few studies have examined sleep disturbances early after injury in this population. This study evaluated the prevalence of self-reported sleep disturbances among older trauma survivors using PROMIS-based assessments within the Trauma Medical Home (TMH) care model to identify modifiable factors that may inform early, patient-centered interventions.

In this cross-sectional study, we conducted a secondary analysis of data from the Collaborative Care for Injured Older Adults: The Trauma Medical Home Randomized Clinical Trial (TMH) study. 144 patients 50 years of age and older admitted for traumatic injury into four trauma centers reported their sleep quality using Patient-Reported Outcomes Measurement Information System Sleep Disturbance Short Form 4a (PROMIS-SF). Symptoms of depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS), of post-traumatic stress using Post Traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C), and pain intensity using Pain, Enjoyment of Life, and General Activity Scale (PEG) scale. Comorbidities were quantifiedusing the Charlson Comorbidity Index (CCI), and trauma severity using the Injury Severity Score (ISS). Logistic regression was used to examine associations between sleep disturbances and psychological and clinical factors.

Approximately 22% of patients reported sleep disturbances. Patients with PTSD or pain symptoms had significantly higher odds of reporting sleep disturbances (OR for PTSD = 13.21, 95% CI = [2.90, 61.17], p = 0.001; OR for pain = 1.33, 95% CI = [1.11, 1.60], p = 0.002).

This study extends prior research by focusing on older adult trauma survivors and assessing sleep disturbances during the immediate post-injury period using PROMIS-based patient-reported outcomes within the Trauma Medical Home (TMH) care model. This approach provides new insight into early, multidimensional symptom patterns and identifies modifiable factors that can inform timely, patient-centered interventions to improve recovery.