Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, Madrid, Spain.
Servicio de Neurocirugía, Neuropsicología Clínica, Hospital Universitario 12 de Octubre, Madrid, Spain.
Neurocirugia (Astur : Engl Ed). 2021 Jul-Aug;32(4):178-187. doi: 10.1016/j.neucie.2020.12.001. Epub 2020 Dec 30.
The purpose of the review is to collect the most relevant current literature on the mechanisms of normal sleep and sleep disorders associated with traumatic brain injury (TBI), to discuss the most frequent conditions and the evidence on their possible treatments and future research. Sleep disorders are extremely prevalent after TBI (30-84%). Insomnia and circadian rhythm disorders are the most frequent disorders among the population that has suffered mild TBI, while hypersomnolence disorders are more frequent in populations that have suffered moderate and severe TBI. The syndrome of obstructive sleep apnea and restless leg syndrome are also very frequent in these patients; and patients exposed to multiple TBIs (war veterans) are especially susceptible to sleep disorders. The treatment of these disorders requires taking into account the particularities of these patients. In conclusion, diagnosis and treatment of sleep disorders should become part of routine clinical practice and cease to be anecdotal (as it is today) in patients with TBI. In addition, it is necessary to continue carrying out research that reveals the best therapeutic approach to these patients.
本次综述的目的在于收集目前有关正常睡眠和与创伤性脑损伤（TBI）相关睡眠障碍的机制的最相关文献，讨论最常见的病症及其可能的治疗方法和未来研究的证据。TBI 后睡眠障碍极其常见（30-84%）。失眠和昼夜节律紊乱是轻 TBI 人群中最常见的睡眠障碍，而嗜睡障碍在中重度 TBI 人群中更为常见。阻塞性睡眠呼吸暂停和不安腿综合征在这些患者中也非常常见；并且，遭受多次 TBI（退伍军人）的患者尤其容易出现睡眠障碍。这些障碍的治疗需要考虑这些患者的特殊性。总之，TBI 患者的睡眠障碍的诊断和治疗应该成为常规临床实践的一部分，而不是像今天这样只是轶事（as it is today）。此外，有必要继续开展研究，揭示这些患者的最佳治疗方法。
