Department of Clinical Neuroscience Division of Physical Medicine and Rehabilitation - University of Calgary, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada; Hotchkiss Brain Institute (HBI), University of Calgary, Calgary, AB, Canada.
Faculty of Medicine and Dentistry - University of Alberta, Calgary, AB, Canada.
Sleep Med. 2024 Jul;119:406-416. doi: 10.1016/j.sleep.2024.05.030. Epub 2024 May 16.
The primary aim of this study was to characterize sleep in adults with persistent post-concussive symptoms (PPCS). Secondary aims explored relationships between sleep parameters, injury characteristics, and symptom questionnaires.
This case-controlled, cross-sectional study recruited adults (18-65yrs) diagnosed with PPCS and age and sex-matched controls. Participants wore a wrist-worn actigraph for 3-7 nights and completed daily sleep diaries. Participants completed questionnaires examining daytime sleepiness, fatigue, anxiety/depressive symptoms, and sedentariness. Sleep parameters were compared between groups using Mann-Whitney U tests. Secondary analyses used two-way ANOVA and Spearman's rank correlations.
Fifty adults with PPCS (43.7 ± 10.6yrs, 78 % female) and 50 controls (43.6 ± 11.0yrs) were included in this study. Adults with PPCS had significantly longer sleep onset latency (PPCS 16.99 ± 14.51min, Controls 8.87 ± 6.44min, p < 0.001) and total sleep time (PPCS 8.3 ± 1.0hrs, Control 7.6 ± 0.9hrs, p = 0.030) compared to controls, but woke up later (PPCS 7:57:27 ± 1:36:40, Control 7:17:16 ± 0:50:08, p = 0.026) and had poorer sleep efficiency (PPCS 77.9 ± 7.5 %, Control 80.8 ± 6.0 %, p = 0.019) than controls. Adults with PPCS reported more daytime sleepiness (Epworth Sleepiness Scale: PPCS 8.70 ± 4.61, Control 4.28 ± 2.79, p < 0.001) and fatigue (Fatigue Severity Scale: PPCS 56.54 ± 12.92, Control 21.90 ± 10.38, p < 0.001). Injury characteristics did not significantly affect sleep parameters in adults with PPCS. Actigraphy parameters were not significantly correlated to questionnaire measures.
Several actigraphy sleep parameters were significantly altered in adults with PPCS compared to controls, but did not correlate with sleep questionnaires, suggesting both are useful tools in characterizing sleep in PPCS. Further, this study provides potential treatment targets to improve sleep difficulties in adults with PPCS.
本研究的主要目的是描述持续性脑震荡后症状（PPCS）成人的睡眠特征。次要目的是探索睡眠参数与损伤特征和症状问卷之间的关系。
本病例对照、横断面研究招募了被诊断为 PPCS 的成年人（18-65 岁）和年龄及性别匹配的对照组。参与者佩戴腕戴式活动记录仪 3-7 晚，并每天填写睡眠日记。参与者完成了评估日间嗜睡、疲劳、焦虑/抑郁症状和久坐行为的问卷。使用 Mann-Whitney U 检验比较两组之间的睡眠参数。使用双向方差分析和 Spearman 秩相关进行二次分析。
本研究纳入了 50 名 PPCS 成年人（43.7±10.6 岁，78%为女性）和 50 名对照组（43.6±11.0 岁）。与对照组相比，PPCS 成人的睡眠潜伏期（PPCS 16.99±14.51min，对照组 8.87±6.44min，p<0.001）和总睡眠时间（PPCS 8.3±1.0 小时，对照组 7.6±0.9 小时，p=0.030）明显更长，但醒来更晚（PPCS 7:57:27±1:36:40，对照组 7:17:16±0:50:08，p=0.026）且睡眠效率更差（PPCS 77.9±7.5%，对照组 80.8±6.0%，p=0.019）。与对照组相比，PPCS 成人报告了更多的日间嗜睡（Epworth 嗜睡量表：PPCS 8.70±4.61，对照组 4.28±2.79，p<0.001）和疲劳（疲劳严重程度量表：PPCS 56.54±12.92，对照组 21.90±10.38，p<0.001）。损伤特征并未显著影响 PPCS 成人的睡眠参数。活动记录仪参数与问卷测量无显著相关性。
与对照组相比，PPCS 成人的几项活动记录仪睡眠参数明显改变，但与睡眠问卷无相关性，这表明两者都是描述 PPCS 睡眠的有用工具。此外，本研究为改善 PPCS 成人的睡眠困难提供了潜在的治疗靶点。
