ABSTRACT

The literature examining the relationship between sleep disturbance, fatigue, and cognition in premorbidly healthy civilian adults after mTBI is very limited. The current study aimed to investigate the relationships of sleep disturbance and fatigue with cognition while controlling for psychological distress and age. Using a prospective observational design, we assessed 60 premorbidly healthy individuals approximately 8 weeks after mTBI. Participants were assessed with the Pittsburgh Sleep Quality Index and the Multidimensional Fatigue Inventory as well as measures of speed of information processing, attention, memory, and executive function; depression and anxiety were also assessed. Findings revealed associations between sleep disturbance and cognition (r²= .586, p < .001) as well as between fatigue and cognition (r²= .390, p < .01), independent of the impact of psychological status and age. Associations were evident in the domains of processing speed, attention, and memory, but were most consistently apparent on measures of executive function. Greater sleep disturbance was most consistently associated with poorer cognitive function. Unexpectedly, higher levels of fatigue were associated with better cognitive function, which may be explained by the coping hypothesis. Given sleep interventions have been shown to improve sleep disturbance, these findings suggest that sleep intervention may also result in improved cognition after mTBI.

摘要

研究 mTBI 后病前健康的平民成人睡眠障碍、疲劳和认知之间关系的文献非常有限。目前的研究旨在调查睡眠障碍和疲劳与认知的关系，同时控制心理困扰和年龄。使用前瞻性观察设计，我们在 mTBI 后大约 8 周评估了 60 名病前健康个体。参与者接受了匹兹堡睡眠质量指数和多维疲劳量表以及信息处理速度、注意力、记忆力和执行功能的评估；还评估了抑郁和焦虑。研究结果揭示了睡眠障碍与认知之间的关联 ( r ² = .586, p < .001) 以及疲劳和认知之间 ( r ² = .390, p  < .01)，独立于心理状态和年龄的影响。关联在处理速度、注意力和记忆力领域很明显，但在执行功能的测量中最为明显。更严重的睡眠障碍与较差的认知功能最一致。出乎意料的是，较高的疲劳程度与更好的认知功能有关，这可以用应对假设来解释。鉴于睡眠干预已被证明可以改善睡眠障碍，这些发现表明睡眠干预也可能导致 mTBI 后认知能力的改善。