Sleep Disturbances After Whiplash Injury: Objective and Subjective Findings

Abstract

Objective.—A controlled objective and subjective evaluation of sleep in a consecutive series of persons who had had a whiplash injury, shortly following the injury and 3 to 5 months later.Methods.—In whiplash‐injured subjects and healthy controls, sleep characteristics were monitored objectively throughout the night by means of an actigraph. The following morning, participants in both groups filled out a prestructured “sleep log” that conveyed their subjective impressions as to how they had slept. The correlation between objectively measured sleep characteristics and the symptoms and physical findings, respectively, resulting from whiplash injury were also examined.Results.—Actigraphic monitoring did not reveal a significant group difference between whiplash‐injured subjects and controls with respect to any of the sleep characteristics recorded. In self‐maintained “sleep logs,” however, the whiplash‐injured subjects reported a significantly prolonged sleep latency and significantly impaired sleep quality compared with controls (P<.001 and P<.04, respectively). In whiplash‐injured subjects, the number of arousals was positively correlated with the number of symptoms and with the number of physical signs of whiplash injury (P<.01 and P<.001, respectively). Sleep efficiency was inversely correlated with the number of injury‐related findings on physical examination (P<.009).Conclusion.—Sleep, as monitored by actigraph in whiplash‐injured subjects, was not adversely affected by whiplash injury. The subjective impressions of the subjects, as recorded in “sleep logs,” suggest the opposite conclusion. A significant correlation exists between certain symptoms and signs of whiplash injury and abnormalities in given sleep characteristics as detected by actigraph.