Circadian rhythm sleep disorders following mild traumatic brain injury
Circadian rhythm sleep disorders following mild traumatic brain injury
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DOI：
10.1212/01.wnl.0000258672.52836.30
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发表时间：
2007-04-03
期刊：
影响因子：
9.9
通讯作者：
Dagan, Y.
中科院分区：
文献类型：
--
作者：
Ayalon, L.;Borodkin, K.;Dagan, Y.
目的：描述轻度创伤性脑损伤（mTBI）后失眠患者昼夜节律睡眠障碍（CRSD）的生理和行为特征。方法：对42例mTBI后出现失眠症状的患者进行筛选。那些怀疑患有CRSD的人接受了活动记录仪，唾液褪黑激素和口腔温度测量，以及多导睡眠图。所有的病人还填写了一份自我报告的问卷，以确定他们的昼夜节律偏好。结果：42例mTBI后主诉失眠的患者中有15例（36%）被诊断为CRSD。8例患者表现为睡眠时相延迟综合征（DSPS），而7例患者表现为不规则的睡眠-觉醒模式（ISWP）。而所有的DSPS患者表现出24小时周期性的口腔温度节律，3/7例ISWP患者缺乏这样的每日节律。此外，ISWP患者口腔温度节律的幅度小于DSPS组。主观晨-晚问卷评分与腕动计诊断的DSPS或ISWP一致。结论：轻度颅脑损伤可能与昼夜节律性睡眠障碍的发生有关。观察到两种类型的这些障碍：睡眠时相延迟综合征和不规则的睡眠-觉醒模式。不同类型的主观问卷得分不同，褪黑激素和温度昼夜节律有不同的配置文件。
Objective: To describe the physiologic and behavioral characteristics of circadian rhythm sleep disorders (CRSDs) following minor traumatic brain injury (mTBI) in patients complaining of insomnia. Methods: Forty two patients with insomnia complaints following mTBI were screened. Those suspected of having CRSD underwent actigraphy, saliva melatonin and oral temperature measurement, and polysomnography. All patients also filled out a self- reported questionnaire to determine their circadian preference. Results: Fifteen of the 42 patients (36%) with complaints of insomnia following mTBI were diagnosed with CRSD. Eight patients displayed a delayed sleep phase syndrome (DSPS), whereas seven displayed an irregular sleep-wake pattern (ISWP). Whereas all patients with DSPS exhibited a 24- hour periodicity of oral temperature rhythm, three of seven patients with ISWP lacked such a daily rhythm. In addition, ISWP patients exhibited smaller amplitude of oral temperature rhythm vs the DSPS group. Subjective Morningness-Eveningness Questionnaire scores were in accordance with the clinical diagnosis of DSPS or ISWP based on actigraphy. Conclusions: Minor traumatic brain injury might contribute to the emergence of circadian rhythm sleep disorders. Two types of these disorders were observed: delayed sleep phase syndrome and irregular sleep-wake pattern. The types differed in the subjective questionnaire scores and had distinct profiles of melatonin and temperature circadian rhythms.