Defense and Veterans Brain Injury Center, James A. Haley VA Hospital, Tampa, Florida, USA.
Mental Health and Behavioral Sciences and Defense and Veterans Brain Injury Center, James A. Haley VA Hospital, Tampa, Florida, USA.
J Neurotrauma. 2020 Dec 1;37(23):2517-2527. doi: 10.1089/neu.2019.6916. Epub 2020 Sep 1.
The contribution of sleep disturbance to persistent cognitive symptoms following a mild traumatic brain injury (mTBI) remains unclear. Obstructive sleep apnea (OSA) is very common, yet its relationship between risk factors for developing OSA and cognitive performance in those with history of mTBI has not been investigated. The current study examined OSA risk levels and its association with cognitive performance in 391 combat-exposed, post-911 veterans and service members (median age = 37 years) enrolled in the Chronic Effects of Neurotrauma Consortium (CENC) prospective multi-center study. Participants included those with and without mTBI ( = 326 and 65, respectively). When using clinical cut-offs, those with history of mTBI were more likely to be categorized as high risk for OSA (mTBI positive = 65% vs. mTBI negative = 51%). After adjustment for TBI status and demographic variables, increased OSA risk was significantly associated with worse performance on measures of complex processing speed and executive functioning ( Coding, Trail Making Test, part B) and greater symptom burden (Neurobehavioral Symptom Inventory). Thus, OSA, a modifiable behavioral health factor, likely contributes to cognitive performance following mTBI. Accordingly, OSA serves as a potential point of intervention to improve clinical and cognitive outcomes after injury.
睡眠障碍对轻度创伤性脑损伤（mTBI）后持续认知症状的影响仍不清楚。阻塞性睡眠呼吸暂停（OSA）非常常见，但尚未研究其与 mTBI 病史患者的 OSA 风险因素和认知表现之间的关系。本研究在慢性神经创伤影响联合会（CENC）前瞻性多中心研究中，检查了 391 名参战的、911 年后的退伍军人和现役军人（中位数年龄为 37 岁）的 OSA 风险水平及其与认知表现的关系。参与者包括有和没有 mTBI 的人（分别为 326 人和 65 人）。使用临床切点时，有 mTBI 病史的人更有可能被归类为 OSA 高风险（mTBI 阳性者=65%，mTBI 阴性者=51%）。在调整了 TBI 状况和人口统计学变量后，较高的 OSA 风险与复杂处理速度和执行功能（编码、TMT 测试，B 部分）以及更大的症状负担（神经行为症状清单）的表现更差显著相关。因此，OSA 作为一种可改变的行为健康因素，可能会影响 mTBI 后的认知表现。因此，OSA 可能成为受伤后改善临床和认知结果的潜在干预点。
