Mollayeva Tatyana, Colantonio Angela, Cassidy J David, Vernich Lee, Moineddin Rahim, Shapiro Colin M
Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Collaborative Program in Neuroscience, University of Toronto, Canada; Toronto Rehab-University Health Network, Ontario, Canada.
Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, Canada.
Sleep Med. 2017 Jun;34:179-192. doi: 10.1016/j.sleep.2017.02.021. Epub 2017 Mar 18.
Sleep stage disruption in persons with mild traumatic brain injury (mTBI) has received little research attention. We examined deviations in sleep stage distribution in persons with mTBI relative to population age- and sex-specific normative data and the relationships between such deviations and brain injury-related, medical/psychiatric, and extrinsic factors.
We conducted a cross-sectional polysomnographic investigation in 40 participants diagnosed with mTBI (mean age 47.54 ± 11.30 years; 56% males).
At the time of investigation, participants underwent comprehensive clinical and neuroimaging examinations and one full-night polysomnographic study. We used the 2012 American Academy of Sleep Medicine recommendations for recording, scoring, and summarizing sleep stages. We compared participants' sleep stage data with normative data stratified by age and sex to yield z-scores for deviations from available population norms and then employed stepwise multiple regression analyses to determine the factors associated with the identified significant deviations.
In patients with mTBI, the mean duration of nocturnal wakefulness was higher and consolidated sleep stage N2 and REM were lower than normal (p < 0.0001, p = 0.018, and p = 0.010, respectively). In multivariate regression analysis, several covariates accounted for the variance in the relative changes in sleep stage duration. No sex differences were observed in the mean proportion of non-REM or REM sleep.
We observed longer relative nocturnal wakefulness and shorter relative N2 and REM sleep in patients with mTBI, and these outcomes were associated with potentially modifiable variables. Addressing disruptions in sleep architecture in patients with mTBI could improve their health status.
轻度创伤性脑损伤（mTBI）患者的睡眠阶段紊乱很少受到研究关注。我们研究了mTBI患者睡眠阶段分布相对于特定年龄和性别的人群标准数据的偏差，以及这些偏差与脑损伤相关、医学/精神因素和外在因素之间的关系。
我们对40名被诊断为mTBI的参与者（平均年龄47.54±11.30岁；56%为男性）进行了横断面多导睡眠图调查。
在调查时，参与者接受了全面的临床和神经影像学检查以及一次整夜的多导睡眠图研究。我们使用2012年美国睡眠医学学会关于记录、评分和总结睡眠阶段的建议。我们将参与者的睡眠阶段数据与按年龄和性别分层的标准数据进行比较，以得出偏离现有人群标准的z分数，然后采用逐步多元回归分析来确定与所识别的显著偏差相关的因素。
在mTBI患者中，夜间清醒的平均时长较高，而巩固睡眠阶段N2和快速眼动（REM）睡眠低于正常水平（分别为p<0.0001、p = 0.018和p = 0.010）。在多变量回归分析中，几个协变量解释了睡眠阶段时长相对变化中的差异。在非快速眼动睡眠或快速眼动睡眠的平均比例方面未观察到性别差异。
我们观察到mTBI患者夜间相对清醒时间更长，相对N2和REM睡眠更短，并且这些结果与潜在可改变的变量相关。解决mTBI患者的睡眠结构紊乱问题可能会改善他们的健康状况。
