创伤性脑损伤中的睡眠

Sleep in traumatic brain injury.

作者信息

Vermaelen James, Greiffenstein Patrick, deBoisblanc Bennett P

机构信息

Section of Pulmonary & Critical Care Medicine, Louisiana State University Health Sciences Center, 1901 Perdido Street, Suite 3205, New Orleans, LA 70112, USA.

Section of Trauma and Critical Care Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70112, USA.

出版信息

Crit Care Clin. 2015 Jul;31(3):551-61. doi: 10.1016/j.ccc.2015.03.012. Epub 2015 Apr 29.

DOI:10.1016/j.ccc.2015.03.012

PMID:26118920

Abstract

More than one-half million patients are hospitalized annually for traumatic brain injury (TBI). One-quarter demonstrate sleep-disordered breathing, up to 50% experience insomnia, and half have hypersomnia. Sleep disturbances after TBI may result from injury to sleep-regulating brain tissue, nonspecific neurohormonal responses to systemic injury, ICU environmental interference, and medication side effects. A diagnosis of sleep disturbances requires a high index of suspicion and appropriate testing. Treatment starts with a focus on making the ICU environment conducive to normal sleep. Treating sleep-disordered breathing likely has outcome benefits in TBI. The use of sleep promoting sedative-hypnotics and anxiolytics should be judicious.

摘要

每年有超过50万患者因创伤性脑损伤（TBI）住院。四分之一的患者出现睡眠呼吸障碍，高达50%的患者有失眠症状，半数患者有嗜睡症状。TBI后的睡眠障碍可能源于调节睡眠的脑组织损伤、对全身损伤的非特异性神经激素反应、重症监护病房（ICU）环境干扰以及药物副作用。睡眠障碍的诊断需要高度的怀疑指数和适当的检查。治疗首先要注重使ICU环境有利于正常睡眠。治疗睡眠呼吸障碍可能对TBI的预后有益。使用促进睡眠的镇静催眠药和抗焦虑药应谨慎。