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How client-centred science uncovers the complexity of post-injury sleep



By Professor John A Groeger and Kate Bosak of Nottingham Trent University's Sleep Well Science project.

Sleep responds systematically to gradual biological changes that see us develop from being children into adolescents, from women who might give birth to no longer ovulating, and as we approach and hopefully enjoy old age.

We conceptualise these changes in our capacity to have restorative sleep as the waxing, waning, and interplay of two pervasive influences - circadian fluctuation and the build-up and release of sleep pressure. Abrupt challenges to either process, such as losing a night’s sleep or intercontinental travel, immediately bring home the easy dependence we typically have on these continuous influences on our lives. 

For most of us, these challenges are either temporary, which allows us to re-adjust, or gradual, which allows a more easily paced adaptation of life’s demands, lifestyles and the sleep which enables recovery and change.

This is not the case for those who encounter events which result in major trauma- which NICE defines as “an injury or combination of injuries that are life-threatening and could be life changing because it may result in long-term disability”. 

What we may not realise is that the profile of those living after major injury has changed very dramatically over the last couple of decades.

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