Cargando…
Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis
INTRODUCTION: Sleep disturbances are common following traumatic brain injury (TBI) worsening morbidity and other neuropsychiatric symptoms. Post-TBI alterations in sleep architecture require further study. OBJECTIVES: (1) To evaluate polysomnographic measures of sleep architecture in participants wi...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9567999/ http://dx.doi.org/10.1192/j.eurpsy.2022.2091 |
_version_ | 1784809539471671296 |
---|---|
author | Bray, M. Krieg, A. Esagoff, A. Bryant, B. Salas, R. Rao, V. Peters, M. |
author_facet | Bray, M. Krieg, A. Esagoff, A. Bryant, B. Salas, R. Rao, V. Peters, M. |
author_sort | Bray, M. |
collection | PubMed |
description | INTRODUCTION: Sleep disturbances are common following traumatic brain injury (TBI) worsening morbidity and other neuropsychiatric symptoms. Post-TBI alterations in sleep architecture require further study. OBJECTIVES: (1) To evaluate polysomnographic measures of sleep architecture in participants with history of TBI compared to controls and as meta-analyses of pooled means. (2) To evaluate effects of timing and severity of TBI on polysomnographic outcomes. METHODS: PRISMA compliant systematic review was conducted of MEDLINE, PsycINFO, EMBASE and Scopus. Inclusion criteria: 1) reporting polysomnography in the context of TBI and 2) operationalizing TBI using clear/formalized criteria. Data were pooled in random-effects meta-analyses with outcomes expressed as mean differences (MD). RESULTS: In participants with TBI, sleep was comprised of 19.39% REM sleep, 8.13% N1, 51.18% N2, and 17.53% N3, as determined by meta-analyses of single means. Total sleep time was reduced in chronic (>6 months) TBI compared to acute-intermediate TBI (<6 months) (p=0.01). Compared to controls, participants with TBI differed with increased N1 sleep (MD=0.64%; 95%CI=0.02,1.25; p=0.04), reduced sleep efficiency (MD=-1.65%; 95%CI=-3.18,-0.12; p=0.03), and reduced sleep latency on the multiple sleep latency test (MD=-5.90mins; 95%CI=-10.09,-1.72; p<0.01). On sub-group analyses, participants with mild TBI differed from controls with reduced total sleep time (MD=-29.22mins, 95%CI=-54.16,-4.27; p=0.02). Similarly, participants with acute-intermediate TBI exhibited increased sleep latency compared to controls (MD=8.96mins; 95%CI=4.07,13.85; p<0.01) and differed significantly from participants with chronic TBI (X(2) (1,N=608)=6.54; p=0.01). CONCLUSIONS: Sleep architecture is altered following TBI with potential implications regarding functional outcomes and recovery. These alterations appear to differ based on severity of injury and time since injury. DISCLOSURE: No significant relationships. |
format | Online Article Text |
id | pubmed-9567999 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-95679992022-10-17 Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis Bray, M. Krieg, A. Esagoff, A. Bryant, B. Salas, R. Rao, V. Peters, M. Eur Psychiatry Abstract INTRODUCTION: Sleep disturbances are common following traumatic brain injury (TBI) worsening morbidity and other neuropsychiatric symptoms. Post-TBI alterations in sleep architecture require further study. OBJECTIVES: (1) To evaluate polysomnographic measures of sleep architecture in participants with history of TBI compared to controls and as meta-analyses of pooled means. (2) To evaluate effects of timing and severity of TBI on polysomnographic outcomes. METHODS: PRISMA compliant systematic review was conducted of MEDLINE, PsycINFO, EMBASE and Scopus. Inclusion criteria: 1) reporting polysomnography in the context of TBI and 2) operationalizing TBI using clear/formalized criteria. Data were pooled in random-effects meta-analyses with outcomes expressed as mean differences (MD). RESULTS: In participants with TBI, sleep was comprised of 19.39% REM sleep, 8.13% N1, 51.18% N2, and 17.53% N3, as determined by meta-analyses of single means. Total sleep time was reduced in chronic (>6 months) TBI compared to acute-intermediate TBI (<6 months) (p=0.01). Compared to controls, participants with TBI differed with increased N1 sleep (MD=0.64%; 95%CI=0.02,1.25; p=0.04), reduced sleep efficiency (MD=-1.65%; 95%CI=-3.18,-0.12; p=0.03), and reduced sleep latency on the multiple sleep latency test (MD=-5.90mins; 95%CI=-10.09,-1.72; p<0.01). On sub-group analyses, participants with mild TBI differed from controls with reduced total sleep time (MD=-29.22mins, 95%CI=-54.16,-4.27; p=0.02). Similarly, participants with acute-intermediate TBI exhibited increased sleep latency compared to controls (MD=8.96mins; 95%CI=4.07,13.85; p<0.01) and differed significantly from participants with chronic TBI (X(2) (1,N=608)=6.54; p=0.01). CONCLUSIONS: Sleep architecture is altered following TBI with potential implications regarding functional outcomes and recovery. These alterations appear to differ based on severity of injury and time since injury. DISCLOSURE: No significant relationships. Cambridge University Press 2022-09-01 /pmc/articles/PMC9567999/ http://dx.doi.org/10.1192/j.eurpsy.2022.2091 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Bray, M. Krieg, A. Esagoff, A. Bryant, B. Salas, R. Rao, V. Peters, M. Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis |
title | Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis |
title_full | Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis |
title_fullStr | Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis |
title_short | Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis |
title_sort | polysomnography following traumatic brain injury: a systematic review and meta-analysis |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9567999/ http://dx.doi.org/10.1192/j.eurpsy.2022.2091 |
work_keys_str_mv | AT braym polysomnographyfollowingtraumaticbraininjuryasystematicreviewandmetaanalysis AT kriega polysomnographyfollowingtraumaticbraininjuryasystematicreviewandmetaanalysis AT esagoffa polysomnographyfollowingtraumaticbraininjuryasystematicreviewandmetaanalysis AT bryantb polysomnographyfollowingtraumaticbraininjuryasystematicreviewandmetaanalysis AT salasr polysomnographyfollowingtraumaticbraininjuryasystematicreviewandmetaanalysis AT raov polysomnographyfollowingtraumaticbraininjuryasystematicreviewandmetaanalysis AT petersm polysomnographyfollowingtraumaticbraininjuryasystematicreviewandmetaanalysis |