Parcell Diane L, Ponsford Jennie L, Rajaratnam Shantha M, Redman Jennifer R
School of Psychology, Psychiatry and Psychological Medicine, Monash University, Victoria, Australia.
Arch Phys Med Rehabil. 2006 Feb;87(2):278-85. doi: 10.1016/j.apmr.2005.10.024.
To explore subjective sleep reports from people in the chronic stages of traumatic brain injury (TBI) and to examine the extent and nature of sleep complaints in this population.
Survey.
All participants were community based at the time of data collection.
Sixty-three subjects with TBI consecutively recruited after discharge from rehabilitation and 63 age- and sex-matched controls from the general community.
Not applicable.
A 7-day self-reported sleep-wake diary assessing sleep and wake times, sleep onset latency, frequency, and duration of nocturnal awakenings and daytime naps; a general sleep questionnaire used to evaluate sleep changes and quality; and the Epworth Sleepiness Scale to measure daytime sleepiness.
Group-wise comparisons showed a significantly higher frequency of reported sleep changes after TBI (80%) relative to the control group (23%), supporting previous findings. The TBI group reported more nighttime awakenings and longer sleep onset latency; these changes were more frequently reported by participants with TBI with milder injuries. Increased levels of anxiety and depression were associated with increased reporting of sleep changes.
These findings confirm the experience of changes to sleep after TBI and may at least in part account for the reported increased daytime sleepiness in this population. Sleep disturbance should be addressed during rehabilitation. Treatments need to focus on correcting the underlying cause of the sleep problem and to address patients' subjective experiences of their sleep, possibly through education and mood stabilization.
探讨创伤性脑损伤（TBI）慢性期患者的主观睡眠报告，并研究该人群睡眠问题的程度和性质。
调查。
所有参与者在数据收集时均为社区居民。
63名康复出院后连续招募的TBI患者以及63名来自普通社区的年龄和性别匹配的对照者。
不适用。
一份为期7天的自我报告的睡眠-觉醒日记，评估睡眠时间和觉醒时间、入睡潜伏期、夜间觉醒频率和持续时间以及白天小睡情况；一份用于评估睡眠变化和质量的一般睡眠问卷；以及用于测量白天嗜睡程度的爱泼华嗜睡量表。
分组比较显示，与对照组（23%）相比，TBI患者报告的睡眠变化频率显著更高（80%），这支持了先前的研究结果。TBI组报告夜间觉醒次数更多且入睡潜伏期更长；损伤较轻的TBI患者更频繁地报告这些变化。焦虑和抑郁水平升高与睡眠变化报告增加有关。
这些发现证实了TBI后睡眠会发生变化，这可能至少部分解释了该人群中报告的白天嗜睡增加的现象。在康复过程中应解决睡眠障碍问题。治疗需要专注于纠正睡眠问题的根本原因，并解决患者对其睡眠的主观体验，可能通过教育和情绪稳定来实现。
