Circadian-Informed Analysis of Sleep Disruptions in Traumatic Brain Injury: Insights from Wearable Monitoring and Sleep Deprivation
Objective:
To investigate how traumatic brain injury (TBI) affects the relationship between circadian timing and sleep architecture following sleep deprivation, and to evaluate whether wearable-derived metrics can detect disruptions missed by traditional polysomnography (PSG).
Background:
Traumatic brain injury (TBI) disrupts sleep and circadian rhythms, worsening cognitive and physiological impairments. Sleep deprivation exacerbates these disruptions, yet its effects in TBI remain understudied. Circadian dysfunction is difficult to measure and often mistaken for insomnia, leading to ineffective care. Wearables capture real-world circadian patterns, potentially identifying disruptions missed clinically. This study examines sleep-circadian interactions in sleep-deprived TBI and non-TBI participants.
Design/Methods:
Twenty-five participants (N=9 with TBI) were monitored at home for two weeks using the Oura ring. Circadian parameters, including acrophase and mesor, were derived from skin temperature via cosinor analysis. Midsleep time was calculated from sleep data. After 36 hours of sleep deprivation, participants underwent in-lab polysomnography (PSG) to assess sleep architecture, including rapid eye movement (REM) and non-REM (NREM) epochs. Linear regression models examined how TBI moderates relationships between circadian and sleep metrics (beta: interaction effect). Additional analyses explore whether acrophase mediates the association between TBI and sleep quality.
Results:
Preliminary findings show that TBI participants had earlier circadian timing, with acrophase at 1:55 AM vs. 3:02 AM in non-TBI participants (p<0.05). TBI status moderated the acrophase-midsleep relationship (beta=-0.5, p=0.033), suggesting disrupted circadian alignment. While PSG parameters showed no group differences, wearable-derived measures detected circadian disruptions not captured in-lab. Findings indicate weaker associations between circadian markers and restorative NREM sleep in TBI, suggesting impaired sleep homeostasis.
Conclusions:
Analysis suggests wearables can detect circadian disruptions in TBI that may be missed. Findings indicate earlier circadian timing and impaired sleep-circadian integration in TBI. Wearables provide a non-invasive way to identify subtle disruptions. These results emphasize the need for targeted interventions addressing sleep and circadian dysfunction in TBI populations.
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