Researchers from the Peter O’Donnell Jr. Brain Institute will participate in a national study to determine whether medical devices used in the home can diagnose sleep apnea that often develops after traumatic brain injuries (TBI).

The $2.68 million study will compare the accuracy of formal laboratory screening versus wristwatch-like sensors that TBI patients will wear to measure sleep patterns.

Researchers want to know if wrist actigraphs, if proven comparable to full-scale polysomnography commonly used in sleep labs, would offer a reliable, accessible method to diagnose sleep apnea and lead to earlier treatment. Sleep apnea often goes undiagnosed, which for TBI patients can be a crucial setback in recovery.

“Optimizing sleep is essential for neurorecovery after TBI,” says Kathleen Bell, MD, the project’s investigator at the O’Donnell Brain Institute at UT Southwestern Medical Center and Chair of Physical Medicine and Rehabilitation, in a release.

Funding for the study comes from the Patient-Centered Outcomes Research Institute (PCORI) to further previous work from the multi-institutional team on how TBI affects sleeping patterns.

The team recently published the largest study examining sleep apnea incidence in consecutive admissions to inpatient brain injury rehabilitation. The researchers found that 50% of all brain injury admissions, and 37% of persons with TBI, were diagnosed with sleep apnea.

Up to 3 million TBIs occur in the United States each year, but diagnosing the ensuing cases of sleep disorder has been a challenge because most TBI patients don’t realize they’re at higher risk and are unaware their sleep is being disrupted by snoring or other symptoms.

Bell’s research aims to improve the diagnosis rate by demonstrating whether simpler, home-based technology such as home wrist actigraphs can be just as effective as the thorough testing conducted in a laboratory.

The wrist actigraphs will be upgraded for the study with improved sleep-tracing abilities to determine whether they can be a viable alternative to full-scale polysomnography, which is done in a sleep lab by a technician.

“We know that you can identify disturbances in sleep with wrist actigraphs. What we don’t know is how effective these screening methods are stacked up against one another,” says Bell, who holds the Kimberly-Clark Distinguished Chair in Mobility Research.

The study will begin enrollment in May at six TBI Model System Research Centers across the country, with infrastructure currently funded by the Departments of Health and Human Services, Veterans Affairs, and Department of Defense to examine early and long-term outcomes from brain injury. Risa Richardson, PhD, clinical neuropsychologist at James A. Haley Veterans Hospital in Tampa, Florida, and associate professor of medicine at the University of South Florida, is principal investigator for the national study.

Participants will be selected from inpatients enrolled in the TBI Model Systems.

Other locations for the study include the University of Washington, Seattle; Ohio State University, Columbus, Ohio; Craig Hospital, Denver; Moss Rehabilitation Research Institute, Philadelphia; and North Texas TBI Model System, Dallas. Sleep specialists from the University of South Florida, Stanford University, and North Florida/South Georgia Veterans Health System are also participating.

Bell’s award has been approved by PCORI. PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions.

Image courtesy UT Southwestern Medical Center