Course of Fatigue and Sleep After Moderate to Severe Traumatic Brain Injury.

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Head Trauma Rehabilitation Pub Date : 2025-07-22 DOI:10.1097/HTR.0000000000001078

Jessica Bruijel, Sven Stapert, Annemiek Vermeeren, Julie Staals, Jennie Ponsford, Caroline van Heugten

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引用次数: 0

Abstract

Objective: To examine the development of different dimensions of fatigue and subjective and objective measures of sleep in the first 18 months post moderate to severe traumatic brain injury (TBI), and explore the association with biological (processing speed), psychological (mood), and social (restrictions in participation) factors across time.

Participants: Forty-two participants with moderate-severe TBI (45 ± 16 years old, 33% female).

Design: Longitudinal multicenter observational cohort study with 4 measurements (3, 6, 12, and 18 months post-injury).

Main measures: Dimensions of fatigue (Fatigue Severity Scale, FSS; Dutch Multifactor Fatigue Scale, DMFS), subjective (Pittsburgh Sleep Quality Index, PSQI) and objective sleep (actigraphy), processing speed (Symbol Digit Modalities Task, SDMT), mood (Hospital Anxiety and Depression Scale, HADS), and restrictions in participation (Utrecht Scale for Evaluation and Rehabilitation-Participation, USER-P).

Results: Results showed reduced sleep quality (PSQI: poor sleep quality at 3 months 41%; 6 months 43%; 12 months 56%; 18 months 43%) and high levels of fatigue (FSS: severe fatigue at 3 months 41%; 6 months 38%; 12 months 33%; 18 months 34%) with no significant changes over time. Physical fatigue (DMFS: β = -0.11, P = .007) and total sleep time (β = -0.14, P = .015) decreased over time. More mood problems were associated with worse sleep quality (PSQI; β = 0.35, P = .021), shorter total sleep time (β = 0.14, P = .046), and higher levels of fatigue (FSS: β = 0.20, P = .036; DMFS-mental: β = 0.36, P = .028; DMFS-physical: β = 0.36, P = .029). Restrictions in participation were associated with fatigue but not with sleep.

Conclusions: High and stable levels of fatigue and poor sleep quality in the first 18 months following moderate-severe TBI were found. These symptoms were associated with mood problems. Assessment and treatment of fatigue and sleep problems should be included in clinical practice. In line with other studies, we suggest that mood interventions might aid the treatment for fatigue and sleep quality.

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中重度颅脑外伤后的疲劳和睡眠过程。

目的：探讨中重度颅脑损伤（TBI）后18个月内不同维度疲劳和主客观睡眠指标的发展，并探讨其与生理（加工速度）、心理（情绪）和社会（参与限制）因素的关系。参与者：42例中重度TBI患者（45±16岁，33%为女性）。设计：纵向多中心观察队列研究，包括4项测量（损伤后3、6、12和18个月）。主要测量方法：疲劳量表（疲劳严重性量表，FSS）；荷兰多因素疲劳量表，DMFS)，主观（匹兹堡睡眠质量指数，PSQI）和客观睡眠（活动描记），处理速度（符号数字模式任务，SDMT），情绪（医院焦虑和抑郁量表，HADS），以及参与限制（乌得勒支评估和康复参与量表，USER-P）。结果：结果显示：睡眠质量下降（PSQI）： 3个月时睡眠质量差41%；6个月43%；12个月56%；18个月43%)和高度疲劳(FSS: 3个月严重疲劳41%；6个月38%；12个月33%；18个月（34%），随着时间的推移没有明显的变化。身体疲劳（DMFS: β = -0.11, P = .007）和总睡眠时间（β = -0.14, P = .015）随着时间的推移而减少。更多的情绪问题与更差的睡眠质量(PSQI；β = 0.35, P = 0.021)，总睡眠时间较短（β = 0.14, P = 0.046），疲劳程度较高(FSS: β = 0.20, P = 0.036；DMFS-mental: β = 0.36, P = 0.028；dmfs -物理：β = 0.36, P = 0.029)。限制参与与疲劳有关，但与睡眠无关。结论：在中重度脑外伤后的前18个月，患者存在高度且稳定的疲劳和较差的睡眠质量。这些症状与情绪问题有关。疲劳和睡眠问题的评估和治疗应纳入临床实践。与其他研究一致，我们认为情绪干预可能有助于治疗疲劳和睡眠质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Head Trauma Rehabilitation 医学-康复医学

CiteScore

4.80

自引率

4.20%

发文量

153

审稿时长

6-12 weeks

期刊介绍： The Journal of Head Trauma Rehabilitation is a leading, peer-reviewed resource that provides up-to-date information on the clinical management and rehabilitation of persons with traumatic brain injuries. Six issues each year aspire to the vision of “knowledge informing care” and include a wide range of articles, topical issues, commentaries and special features. It is the official journal of the Brain Injury Association of America (BIAA).