Gerber Markus, Colledge Flora, Pühse Uwe, Holsboer-Trachsler Edith, Zimmerer Stefan, Brand Serge
Department of Sport, Exercise and Health, University Hospital, Basel, Switzerland.
Neuropsychobiology. 2016;73(3):148-59. doi: 10.1159/000444492. Epub 2016 Apr 12.
Although the chance of surviving an aneurysmal subarachnoid haemorrhage (aSAH) has increased steadily, disturbed sleep and persistent psychological complaints are frequently experienced post-ictus. To date, however, few studies have sought to determine whether physiological parameters, such as objectively measured sleep and cortisol secretion, interrelate significantly with low sleep quality and psychological complaints such as depression. Furthermore, there is little evidence as to whether post-ictal complaints differ between aSAH patients and other groups who have experienced stressful medical intervention.
Data on objective and subjective sleep, sleep-related dysfunctional cognitions, psychological functioning and cortisol secretion were collected from 15 patients who had undergone medical intervention for aSAH. Data were also collected from a group of 16 individuals who had undergone surgery for a meningioma and a third group made up of 17 healthy participants.
aSAH patients and meningioma patients had significantly poorer subjective sleep than healthy controls and reported more sleep-related dysfunctional cognitions and hypochondriacal beliefs. They also had a significantly higher morning cortisol response. Finally, a non-significant trend was found showing that aSAH patients and meningioma patients reported poorer psychological functioning than healthy controls.
Following treatment, aSAH patients and meningioma patients experience poorer subjective sleep and some differences in objectively measured sleep, which might be attributable to increased sleep-related dysfunctional cognitions and poorer overall psychological functioning. Differences in cortisol production were also observed, suggesting that some physiological imbalances are still present post-ictus.
尽管动脉瘤性蛛网膜下腔出血(aSAH)患者的生存几率稳步上升,但发病后常出现睡眠障碍和持续的心理问题。然而,迄今为止,很少有研究试图确定诸如客观测量的睡眠和皮质醇分泌等生理参数是否与低睡眠质量以及抑郁等心理问题显著相关。此外,几乎没有证据表明aSAH患者与经历过压力性医疗干预的其他群体在发病后的症状是否存在差异。
收集了15例接受aSAH医疗干预患者的客观和主观睡眠、与睡眠相关的功能失调认知、心理功能及皮质醇分泌的数据。还从一组16例接受脑膜瘤手术的个体以及由17名健康参与者组成的第三组收集了数据。
aSAH患者和脑膜瘤患者的主观睡眠明显比健康对照组差,且报告有更多与睡眠相关的功能失调认知和疑病观念。他们的晨间皮质醇反应也显著更高。最后,发现一个不显著的趋势,即aSAH患者和脑膜瘤患者报告的心理功能比健康对照组差。
治疗后,aSAH患者和脑膜瘤患者的主观睡眠较差,客观测量的睡眠也存在一些差异,这可能归因于与睡眠相关的功能失调认知增加和整体心理功能较差。还观察到皮质醇分泌的差异,表明发病后仍存在一些生理失衡。