Matthews Ellyn E, Signoracci Gina M, Stearns-Yoder Kelly, Brenner Lisa A
Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver Colorado, and University of Arkansas for Medical Sciences College of Nursing, Little Rock, Arkansas (Dr Matthews); Rocky Mountain MIRECC, Denver, Colorado; Departments of Psychiatry and Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora (Drs Signoracci and Brenner); and Rocky Mountain MIRECC, Denver, Colorado (Ms Stearns-Yoder).
J Head Trauma Rehabil. 2016 Mar-Apr;31(2):126-35. doi: 10.1097/HTR.0000000000000216.
Examine sleep-wake disturbance (SWD) characteristics, factors, consequences, and management strategies from the perspective of veterans with chronic stage, moderate/severe traumatic brain injury (TBI).
VA Medical Center, Rocky Mountain.
Nineteen male veterans with post-acute TBI and SWD in the VA Health Administration.
Qualitative descriptive.
Semistructured interviews, Ohio State University TBI-Identification Method, Insomnia Severity Index.
Two main dimensions emerged: "Messed up sleep" and Surviving and Managing SWD. Sleep-wake disturbance has long-term multidimensional features, etiology, consequences, and practice implications. Although SWD may not be consistently discussed with providers, the problem appears to be pervasive in many aspects of the lives of the informants. Difficulty falling asleep, frequent awakenings, and poor sleep quality were common symptoms that were described as intrusive, isolating, and difficult to self-manage. Veterans discussed a host of physical symptoms, mental health issues, environmental, and behavioral factors that contributed to SWD. Medications, sleep apnea treatment, and self-imposed isolation were frequent management strategies. Veterans expressed a willingness to try new approaches and work with providers.
Sleep-wake disturbance among veterans with chronic stage TBI is a multidimensional phenomenon with interplay between comorbidities, contributing factors, effects on functioning, and sleep management strategies. Implications for practice include early and routine evaluation, monitoring, and treatment of SWD. Research is needed to test interventions that address SWD and common TBI comorbidities.
从患有慢性、中度/重度创伤性脑损伤（TBI）的退伍军人角度，研究睡眠-觉醒障碍（SWD）的特征、影响因素、后果及管理策略。
落基山退伍军人医疗中心。
19名在退伍军人健康管理局患有急性创伤性脑损伤和睡眠-觉醒障碍的男性退伍军人。
定性描述性研究。
半结构化访谈、俄亥俄州立大学创伤性脑损伤识别方法、失眠严重程度指数。
出现了两个主要维度：“睡眠紊乱”以及应对和管理睡眠-觉醒障碍。睡眠-觉醒障碍具有长期的多维度特征、病因、后果及实践意义。尽管睡眠-觉醒障碍可能未与医疗服务提供者持续讨论，但该问题在受访者生活的许多方面似乎普遍存在。入睡困难、频繁觉醒和睡眠质量差是常见症状，被描述为侵扰性的、使人孤立的且难以自我管理。退伍军人讨论了一系列导致睡眠-觉醒障碍的身体症状、心理健康问题、环境和行为因素。药物治疗、睡眠呼吸暂停治疗和自我孤立是常见的管理策略。退伍军人表示愿意尝试新方法并与医疗服务提供者合作。
患有慢性创伤性脑损伤的退伍军人的睡眠-觉醒障碍是一种多维度现象，存在合并症、促成因素、对功能的影响及睡眠管理策略之间的相互作用。对实践的启示包括对睡眠-觉醒障碍进行早期和常规评估、监测及治疗。需要开展研究以测试针对睡眠-觉醒障碍和常见创伤性脑损伤合并症的干预措施。
