Larson Eric B
Marianjoy Rehabilitation Hospital, 26W171 Roosevelt Road, Wheaton, IL 60187, USA. Tel.: +1 630 909 8608; Fax: +1 630 909 6572; E-mail:
NeuroRehabilitation. 2018;43(3):297-306. doi: 10.3233/NRE-182534.
Sleep disturbance plays a significant role in cognitive impairment following traumatic brain injury (TBI).
To summarize recent findings that examine sleep disturbance and cognition in TBI.
Epidemiological information on sleep disorders in people with TBI is presented. A simple introduction to the role of sleep in normal cognition provides context for the literature on clinical populations. Current theory on the mechanisms underlying cognitive problems in people with sleep disorder is briefly described. Findings on the relationship between sleep disorder and cognitive problems in TBI is examined in more detail.
Consistent reports of an association between sleep duration and cognition include several studies noting positive associations (shorter sleep duration accompanies cognitive impairment) and others observing negative associations (longer sleep duration accompanies cognitive problems). Both insomnia and hypersomnolence are forms of sleep disturbance that disrupt key mental processes such as memory consolidation. Obstructive sleep apnea, cerebral structural abnormalities, neurochemical changes and psychiatric pathology are implicated.
Additional information is needed on how severity of injury impacts sleep and cognition. Hypothesized mechanisms underlying the effects of sleep on cognition in TBI should be empirically tested. Further, discrepancies between objective and subjective measures of sleep and cognition must be explored.
睡眠障碍在创伤性脑损伤（TBI）后的认知障碍中起重要作用。
总结近期关于TBI中睡眠障碍与认知的研究发现。
介绍了TBI患者睡眠障碍的流行病学信息。简要介绍睡眠在正常认知中的作用，为临床人群的文献提供背景。简要描述了睡眠障碍患者认知问题潜在机制的当前理论。更详细地研究了TBI中睡眠障碍与认知问题之间关系的研究发现。
关于睡眠时间与认知之间关联的一致报告包括多项研究指出的正相关（较短睡眠时间伴随认知障碍）以及其他观察到的负相关（较长睡眠时间伴随认知问题）。失眠和嗜睡都是睡眠障碍的形式，会干扰诸如记忆巩固等关键心理过程。阻塞性睡眠呼吸暂停、脑结构异常、神经化学变化和精神病理学都与之相关。
需要更多关于损伤严重程度如何影响睡眠和认知的信息。TBI中睡眠对认知影响的潜在机制假设应进行实证检验。此外，必须探索睡眠和认知的客观与主观测量之间的差异。
