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.

中文翻译：

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轻度创伤性脑损伤后第一年睡眠-觉醒障碍和疲劳的流行和稳定性。

在这项前瞻性纵向研究中，我们旨在确定具有代表性的大量患者样本（特隆赫姆轻度创伤性脑损伤 [mTBI] 随访研究）中睡眠-觉醒障碍 (SWD) 和疲劳的患病率和稳定性。我们纳入了 378 名 mTBI 患者（16-60 岁）、82 名有骨科损伤的匹配创伤对照组和 83 名匹配的社区对照组。在受伤后 2 周、3 个月和 12 个月评估睡眠需求增加、睡眠质量差、白天过度嗜睡和疲劳。使用混合逻辑回归模型纵向评估临床相关的组差异。在所有时间点，mTBI 患者睡眠需求增加、睡眠质量差和疲劳的发生率均显着高于创伤对照组和社区对照组。在所有时间点，与创伤对照组相比，更多的 mTBI 患者报告了白天过度嗜睡的问题，但不是社区对照组。与无复杂性 mTBI 患者相比，复杂性 mTBI（计算机断层扫描或磁共振成像的颅内发现）患者在所有三个时间点都有更多的疲劳问题。在受伤后 2 周经历 SWD 和疲劳的 mTBI 患者中，大约一半在 3 个月时仍然有问题，在 12 个月时大约有三分之一。有趣的是，我们观察到不同症状测量之间的重叠有限；大量患者报告的是 SWD 或疲劳的一个特定问题，而不是几个问题。总之，我们的结果提供了强有力的证据，表明 mTBI 对 SWD 和疲劳的发展和维持有显着贡献。