Søvnvansker og fatigue etter lette hodeskader

Forskere fra NTNU, St Olavs hospital og University of California har i denne studien undersøkt prevalens og stabilitet av søvnforstyrrelser det første året etter en lett hodeskade. Data er hentet fra den langsgående studien «Trondheim mild traumatic brain injury (mTBI) follow-up study» der 378 pasienter med lette hodeskader ble sammenlignet med 82 ortopediske traumepasienter og 83 friske kontrollpersoner. Søvnbehov, søvnkvalitet, uttalt søvnighet på dagtid og fatigue ble vurdert 2 uker, 3 måneder og 12 måneder etter skade. Prevalens av økt søvnbehov, dårlig søvnkvalitet og fatigue var signifikant høyere på alle tidspunkt hos pasienter med mTBI sammenlignet med både ortopediske traumepasienter og den friske kontrollgruppen. Blant pasienter med mTBI som opplevde søvnvansker og tretthet 2 uker etter skade, hadde fortsatt rundt halvparten problemer etter 3 måneder og omtrent en tredjedel etter 12 måneder.

The Prevalence and Stability of Sleep-Wake Disturbance and Fatigue throughout the First Year after Mild Traumatic Brain Injury

Simen Berg Saksvik, Migle Karaliute, Håvard Kallestad, Turid Follestad, Robert Asarnow, Anne Vik, Asta Kristine Håberg, Toril Skandsen, Alexander Olsen

Studien er publisert i Journal of Neurotrauma

Abstract
In this prospective, longitudinal study, we aimed to determine the prevalence and stability of sleep-wake disturbance (SWD) and fatigue in a large representative sample of patients (Trondheim mild traumatic brain injury [mTBI] follow-up study). We included 378 patients with mTBI (age 16-60), 82 matched trauma controls with orthopedic injuries, and 83 matched community controls. Increased sleep need, poor sleep quality, excessive daytime sleepiness, and fatigue were assessed at 2 weeks, 3 months, and 12 months after injury. Mixed logistic regression models were used to evaluate clinically relevant group differences longitudinally. Prevalence of increased sleep need, poor sleep quality, and fatigue was significantly higher in patients with mTBI than in both trauma controls and community controls at all time points. More patients with mTBI reported problems with excessive daytime sleepiness compared to trauma controls, but not community controls, at all time points. Patients with complicated mTBI (intracranial findings on computed tomography or magnetic resonance imaging) had more fatigue problems compared to those with uncomplicated mTBI, at all three time points. In patients with mTBI who experienced SWDs and fatigue 2 weeks after injury, around half still had problems at 3 months and approximately one third at 12 months. Interestingly, we observed limited overlap between the different symptom measures; a large number of patients reported one specific problem with SWD or fatigue rather than several problems. In conclusion, our results provide strong evidence that mTBI contributes significantly to the development and maintenance of SWDs and fatigue.