Insomnia, Fatigue, and Sleepiness in the First 2 Years After Traumatic Brain Injury: An NIDRR TBI Model System Module Study
Insomnia, Fatigue, and Sleepiness in the First 2 Years After Traumatic Brain Injury: An NIDRR TBI Model System Module Study
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DOI：
10.1097/htr.0b013e318270f91e
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发表时间：
2012-11-01
影响因子：
2.4
通讯作者：
Spielman, Lisa A.
中科院分区：
文献类型：
--
作者：
Cantor, Joshua B.;Bushnik, Tamara;Spielman, Lisa A.
目的：了解中重度TBI患者失眠和创伤后脑损伤（TBI）疲劳（PTBIF）的患病率，探讨PTBIF与失眠的关系及其与预后的关系。设计：横断面研究。环境：五个国家残疾和康复研究所TBI模型系统。参与者：334名TBI患者在2008年至2012年间完成了1年（n = 213）或2年（n = 121）的随访访谈。主要结果：失眠发生率为11%至24%，pptbif发生率为33%至44%。失眠和疲劳均与睡眠障碍、睡眠卫生、生活满意度、焦虑和抑郁有关。pptbif与更严重的残疾和困倦有关。无疲劳的失眠很少见（2%-3%），但无失眠的pptbif发生率为21% - 23%。9%至22%的个体出现共病。结论：虽然pptbif与失眠密切相关，且均与较差的生活质量相关，但它们受多种因素的独立影响，尤其是精神病理和睡眠质量。大多数PTBIF患者没有失眠；pptif似乎与残疾严重程度和白天嗜睡有关，而失眠则与此无关。人口统计学和损伤变量不是失眠或pptbif的有力预测因子。
Objective: To determine the prevalence of insomnia and posttraumatic brain injury (TBI) fatigue (PTBIF) in individuals with moderate to severe TBI, to explore the relationship between PTBIF and insomnia and their association with outcomes. Design: Cross-sectional study. Setting: Five National Institute of Disability and Rehabilitation Research TBI Model Systems. Participants: Three hundred thirty-four individuals with TBI who completed 1-year (n = 213) or 2-year (n = 121) follow-up interviews between 2008 and 2012. Main Outcome Results: Insomnia occurred in 11% to 24% and PTBIF in 33% to 44% of the individuals. Insomnia and fatigue were both related to sleep disturbance, sleep hygiene, satisfaction with life, anxiety, and depression. PTBIF was associated with greater disability and sleepiness. Insomnia without fatigue was rare (2%-3%) but PTBIF without insomnia occurred in 21% to 23% of the individuals. Comorbidity occurred in 9% to 22% of the individuals. Conclusions: Although PTBIF and insomnia are closely related and both associated with poorer quality of life, they are affected independently by a variety of factors, especially psychopathology and sleep quality. A majority of individuals with PTBIF do not have insomnia; and PTBIF appears to be related to disability severity and daytime sleepiness, where insomnia is not. Demographic and injury variables are not strong predictors of insomnia or PTBIF.