老年人创伤性脑损伤后的睡眠障碍：一项对比研究。
Sleep Disturbances Following Traumatic Brain Injury in Older Adults: A Comparison Study.
机构信息
Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan (Drs Wei and Wen); Graduate Institute of Injury Prevention and Control, College of Public Health (Dr Wei), School of Nursing, College of Nursing (C.-Y. Liu, C.-Y. Chen, and Drs Chuang and H.-Y. Chiu), and Research Center of Sleep Medicine (Dr H.-Y. Chiu), Taipei Medical University, Taipei, Taiwan; Biobehavioral Nursing and Health Informatics (Dr Thompson) and Harborview Injury Prevention and Research Center (Dr Thompson), University of Washington, Seattle, Washington; Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan (Dr Su); Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung, Taiwan (Dr P.-Y. Chen); School of Medicine, Chang Gung University, Taoyuan, Taiwan (Dr P.-Y. Chen); Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taiwan (Drs Lin, C.-T. Chen, and C.-C. Chen); and Department of Rehabilitation, Sinwu Branch, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan (H.-T. Chiu).
出版信息
J Head Trauma Rehabil. 2020 Jul/Aug;35(4):288-295. doi: 10.1097/HTR.0000000000000563.
OBJECTIVES
To compare the prevalence of sleep disturbances in older adults with traumatic brain injury (TBI) with that of age- and gender-matched controls and to determine the risk factors for post-TBI sleep disturbances and the effects of post-TBI disturbances on quality of life (QOL).
DESIGN
Cross-sectional case-comparison study.
PARTICIPANTS
Eighty older adults (aged ≥65 years) with first-time TBI more than 3 months since injury and 80 older adults controls without TBI who completed sleep and health-related QOL questionnaires.
RESULTS
Older adults with TBI showed a higher prevalence of obstructive sleep apnea (OSA), insomnia, and daytime sleepiness than older adult controls. Being male, having higher levels of depression and pain, and the presence of insomnia were significantly correlated with the risks of OSA, insomnia, and daytime sleepiness following TBI, respectively. Both OSA and insomnia were significantly correlated with low QOL in older adults with TBI.
CONCLUSIONS
Sleep disturbances are highly prevalent in older adults with TBI. Gender differences, depression severity, and pain level are correlated with the occurrence of post-TBI sleep disturbances. Both OSA and insomnia are regarded as major contributors to low QOL in older people with TBI. Interventions targeted at post-TBI sleep disturbances may improve QOL of older adults.
目的
比较老年创伤性脑损伤（TBI）患者与年龄和性别匹配的对照组中睡眠障碍的发生率，并确定 TBI 后睡眠障碍的危险因素以及 TBI 后睡眠障碍对生活质量（QOL）的影响。
设计
横断面病例对照研究。
参与者
80 名年龄在 65 岁以上的首次 TBI 患者（受伤后超过 3 个月）和 80 名无 TBI 的老年对照者，他们完成了睡眠和健康相关 QOL 问卷。
结果
TBI 后的老年患者的阻塞性睡眠呼吸暂停（OSA）、失眠和日间嗜睡的发生率高于老年对照组。男性、抑郁和疼痛程度较高，以及失眠的存在与 TBI 后 OSA、失眠和日间嗜睡的风险分别显著相关。OSA 和失眠均与 TBI 老年患者的低 QOL 显著相关。
结论
睡眠障碍在老年 TBI 患者中非常普遍。性别差异、抑郁严重程度和疼痛程度与 TBI 后睡眠障碍的发生有关。OSA 和失眠均被认为是 TBI 老年患者低 QOL 的主要原因。针对 TBI 后睡眠障碍的干预措施可能会改善老年患者的 QOL。
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