Raikes Adam C, Schaefer Sydney Y
Motor Rehabilitation and Learning Laboratory, College of Education and Human Services, Utah State University, Logan, UT.
School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ.
Sleep. 2016 Dec 1;39(12):2141-2147. doi: 10.5665/sleep.6314.
A number of subjective and objective studies provide compelling evidence of chronic post-concussion changes in sleep, yet very little is known about the acute effects of concussion on sleep quality and quantity. Therefore, the purpose of this prospective pilot study was to use actigraphy to examine the changes in sleep quality and quantity acutely following concussion at home rather than in a hospital or sleep laboratory.
Seventeen young adults (7 with acute concussion, 10 controls) were recruited for this study. All participants completed two 5-day testing sessions separated by 30 days from intake (controls) or day of injury (concussion). Participants wore actigraphs and kept a sleep journal. Sleep parameter outcomes included nighttime total sleep time (nTST), 24-h total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE). The coefficient of variation (CV) for each sleep parameter was computed for each session.
nTST and TST CV was significantly greater in the concussion group. There is the additional indication that individuals with a concussion may require and obtain more sleep shortly after injury and subsequently have a shorter duration of sleep at 1 mo post-injury. This pattern was not seen in the measures of sleep quality (WASO, SE).
Individuals with a concussion demonstrated increased nighttime sleep duration variability. This increase persisted at 1 mo post-injury and may be associated with previously documented self-reports of poor sleep quality lasting months and years after a concussion. Additionally, this increase may predispose individuals to numerous negative health outcomes if left untreated.
多项主观和客观研究提供了令人信服的证据,证明脑震荡后存在慢性睡眠变化,但对于脑震荡对睡眠质量和数量的急性影响却知之甚少。因此,这项前瞻性试点研究的目的是使用活动记录仪在家中而非医院或睡眠实验室检查脑震荡后睡眠质量和数量的急性变化。
本研究招募了17名年轻人(7名急性脑震荡患者,10名对照组)。所有参与者完成了两个为期5天的测试阶段,从入组(对照组)或受伤当天(脑震荡组)起间隔30天。参与者佩戴活动记录仪并记录睡眠日志。睡眠参数结果包括夜间总睡眠时间(nTST)、24小时总睡眠时间(TST)、睡眠开始后觉醒时间(WASO)和睡眠效率(SE)。计算每个阶段每个睡眠参数的变异系数(CV)。
脑震荡组的nTST和TST的CV显著更高。另外有迹象表明,脑震荡患者在受伤后不久可能需要并获得更多睡眠,随后在受伤后1个月睡眠时间会缩短。这种模式在睡眠质量指标(WASO、SE)中未观察到。
脑震荡患者夜间睡眠时间变异性增加。这种增加在受伤后1个月持续存在,可能与之前记录的脑震荡后持续数月甚至数年的睡眠质量差的自我报告有关。此外,如果不进行治疗,这种增加可能使个体易患多种负面健康后果。