期刊
JOURNAL OF HEAD TRAUMA REHABILITATION
卷 31, 期 2, 页码 108-116出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HTR.0000000000000206
关键词
rehabilitation; brain injury; cognition; sleep
资金
- Department of Veterans Affairs
- Department of Education, National Institute on Disability, Independent Living, and Rehabilitation Research
- VHA Central Office VA TBI Model System Program of Research
- General Dynamics Health Solutions from the Defense and Veterans Brain Injury Center, US Army Medical Research and Material Command (USAMRMC), U. S. Department of Veterans Affairs [W91YTZ-13-C-0015, 1 I50 HX001233-01, W81XWH-13-2-0095]
- General Dynamics Health Solutions from the U. S. Department of Defense Congressionally Directed Medical Research Programs
Objective: Following traumatic brain injury, both sleep dysfunction and cognitive impairment are common. Unfortunately, little is known regarding the potential associations between these 2 symptoms during acute recovery. This study sought to prospectively examine the relationship between ratings of sleep dysfunction and serial cognitive assessments among traumatic brain injury acute neurorehabilitation admissions. Methods: Participants were consecutive admissions to a free-standing rehabilitation hospital following moderate to severe traumatic brain injury (Median Emergency Department Glasgow Coma Scale = 7). Participants were assessed for sleep-wake cycle disturbance (SWCD) and cognitive functioning at admission and with subsequent weekly examinations. Participants were grouped on the basis of presence (SWCD+) or absence (SWCD-) of sleep dysfunction for each examination; groups were equivalent on demographic and injury variables. Individual Growth Curve modeling was used to examine course of Cognitive Test for Delirium performance across examinations. Results: Individual Growth Curve modeling revealed a significant interaction between examination number (ie, time) and SWCD group (beta = -4.03, P < .001) on total Cognitive Test for Delirium score. The SWCD+ ratings on later examinations were predicted to result in lower Cognitive Test for Delirium scores and greater cognitive impairment over time. Conclusions: This study has implications for improving neurorehabilitation treatment, as targeting sleep dysfunction for early intervention may facilitate cognitive recovery.
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