Rehabilitation Centre Klimmendaal, Arnhem, The Netherlands.
Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
Clin Rehabil. 2021 Nov;35(11):1518-1529. doi: 10.1177/02692155211014827. Epub 2021 May 20.
To systematically review the evidence on the treatments of sleep disturbances in individuals with acquired brain injury.
PubMed, Embase, Web of Science, and PsycINFO were searched from inception to January 2021.
Eligibility criteria were (1) participants with mild to severe acquired brain injury from traumatic brain injury and stroke (⩾three months post-injury), (2) individuals aged 16 years and older, (3) participants with self-reported sleep disturbances, (4) controlled group studies and single case (experimental) studies, and (5) interventions aimed at treatment of sleep disturbances. Two researchers independently identified relevant studies and assessed their study quality using the revised Cochrane assessment of bias tool (RoB 2.0) and the risk-of-bias in N-of-1 trials (RoBiNT) scale.
The search yielded 655 records; 11 studies met the inclusion criteria and were included, with a total of 227 participants (207 individuals with traumatic brain injury, 20 stroke patients). Two studies included pharmacological therapy, six studies examined the effects of cognitive behavioral therapy and three studies investigated alternative interventions such as acupuncture.
Although there was heterogeneity in the study quality of the included studies, their outcomes suggest that cognitive behavioral therapy is recommended as treatment of choice for improving sleep in individuals with acquired brain injury, especially for patients with mild to severe traumatic brain injury. Future research should examine the effects of cognitive behavioral therapy in more high-quality randomized controlled designs.
系统回顾关于治疗后天性脑损伤患者睡眠障碍的证据。
从建库到 2021 年 1 月,检索了 PubMed、Embase、Web of Science 和 PsycINFO。
纳入标准为(1)有轻度至重度后天性脑损伤(由创伤性脑损伤和中风引起)的患者(损伤后至少 3 个月),(2)年龄 16 岁及以上,(3)自述有睡眠障碍的个体,(4)对照研究组和单病例(实验)研究,以及(5)针对睡眠障碍的干预措施。两名研究人员独立识别出相关研究,并使用修订后的 Cochrane 偏倚评估工具(RoB 2.0)和 N-of-1 试验风险评估(RoBiNT)量表评估其研究质量。
搜索结果产生了 655 条记录;符合纳入标准的 11 项研究共纳入 227 名参与者(207 名创伤性脑损伤患者,20 名中风患者)。两项研究包括药物治疗,六项研究检查了认知行为疗法的效果,三项研究调查了替代干预措施,如针灸。
尽管纳入研究的研究质量存在异质性,但它们的结果表明,认知行为疗法是改善后天性脑损伤患者睡眠的首选治疗方法,特别是对于轻度至重度创伤性脑损伤患者。未来的研究应在更高质量的随机对照设计中检查认知行为疗法的效果。