Masel B E, Scheibel R S, Kimbark T, Kuna S T
Transitional Learning Center at Galveston, TX 77550, USA.
Arch Phys Med Rehabil. 2001 Nov;82(11):1526-32. doi: 10.1053/apmr.2001.26093.
To determine the prevalence, demographics, and causes of excessive daytime sleepiness in adults with brain injuries after the acute phase of their injury and to investigate the relations between self-report and objective measures of hypersomnolence.
A case series of patients enrolled consecutively into a residential rehabilitation program.
University sleep laboratory, live-in rehabilitation center.
Adults with brain injuries (n = 71); mean time +/- standard deviation from injury to study, 38 +/- 60 months.
A polysomnogram and Multiple Sleep Latency Test (MSLT) were performed in each subject. Each subject also completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires.
Sleep patterns, by polysomnogram. Daytime hypersomnolence, diagnosed by mean sleep latency on the MSLT <or= 10 minutes. Sleep apnea-hypopnea syndrome, diagnosed by Apnea-Hypopnea Index greater than 10 events/hr. Periodic limb movement disorder, diagnosed by a Periodic Leg Movement Index greater than 10 events/hr.
Mean sleep latency was <or= 10 minutes in 47% of the cohort and <or= 5 minutes in 18.3%. Subjects were classified into 3 groups: nonhypersomnolent (n = 38, 53%), hypersomnolent with abnormal indices (n = 12, 17%), or hypersomnolent with normal indices (n = 21, 30%). Among the 3 groups, no significant differences were present in Glasgow Coma Scale score, length of coma, or time since brain injury. No differences across groups were found in nature of the injury, gender, or medications. No significant correlation existed between the ESS or PSQI results and mean sleep latency on the MSLT.
Hypersomnia is common in adults with brain injuries, with a relatively high prevalence of sleep apnea-hypopnea syndrome, periodic limb movement disorder, and posttraumatic hypersomnia. Subjects with objectively measured sleepiness were not identified on self-reporting questionnaires, suggesting their inability to perceive their hypersomnolence.
确定脑损伤成人急性期过后日间过度嗜睡的患病率、人口统计学特征及病因，并研究自我报告与过度嗜睡客观测量指标之间的关系。
一系列连续纳入住院康复项目的患者病例。
大学睡眠实验室、住院康复中心。
脑损伤成人（n = 71）；从受伤到研究的平均时间±标准差为38±60个月。
对每位受试者进行多导睡眠图和多次睡眠潜伏期试验（MSLT）。每位受试者还完成了爱泼沃斯思睡量表（ESS）和匹兹堡睡眠质量指数（PSQI）问卷。
通过多导睡眠图观察睡眠模式。根据MSLT平均睡眠潜伏期≤10分钟诊断日间过度嗜睡。根据呼吸暂停低通气指数大于10次/小时诊断睡眠呼吸暂停低通气综合征。根据周期性腿部运动指数大于10次/小时诊断周期性肢体运动障碍。
47%的队列受试者平均睡眠潜伏期≤10分钟，18.3%的受试者平均睡眠潜伏期≤5分钟。受试者分为3组：非过度嗜睡组（n = 38，53%）、指标异常的过度嗜睡组（n = 12，17%）或指标正常的过度嗜睡组（n = 21，30%）。3组之间在格拉斯哥昏迷量表评分、昏迷时长或脑损伤后的时间方面无显著差异。在损伤性质、性别或用药方面，各组之间未发现差异。ESS或PSQI结果与MSLT平均睡眠潜伏期之间无显著相关性。
嗜睡在脑损伤成人中很常见，睡眠呼吸暂停低通气综合征、周期性肢体运动障碍和创伤后嗜睡的患病率相对较高。客观测量有嗜睡的受试者在自我报告问卷中未被识别出来，表明他们无法察觉自己的过度嗜睡。
