Correct!
3. PSG sleep study

A study of  98,709 veterans with TBI and 98,709 age-matched veterans without TBI (age 49 ± 20 years). After an average follow-up of 5 (1-14) years, 23,127 (19.6%) veterans developed sleep disorders (1). Those with TBI had a 41% increase in sleep disorders compared to those without TBI (hazard ratio 1.41 [95% confidence interval 1.37-1.44]). The association was stronger for mild TBIs, did not differ appreciably by presence of posttraumatic stress disorder, and remained after a 2-year time lag. Therefore, a PSG sleep study seems reasonable. It is unclear how a repeat head CT scan, EEG or brain MRI would be helpful.
PSG showed mild positional OSA with an apnea-hypopnea index (AHI) of 9 events/hour and lowest oxygen saturation of 93% (using 3% hypopnea rule).

What should be done next? (Click on the correct answer to be directed to the third of five pages)

  1. Treat with CPAP
  2. Repeat PSG sleep study
  3. Multiple Sleep Latency Test (MSLT)
  4. 1 or 3
  5. All of the above

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