International Medical Journal, Vol. 20., Iss. 4, 2014, P. 58−61.
STRUCTURAL CHANGES AND MANIFESTATIONS OF CLINICAL VARIANTS OF SLEEP DISORDERS IN LONG-TERM PERIOD OF TRAUMATIC BRAIN INJURY
Ukrainian Railroad Hospital, Ukraine
The purpose of the work was to detect structural and clinical variants of night sleep disorder in patients with the history of brain injury at long−term phase of different severity. Electroencephalography (EEG) of night sleep was performed, clinical variants of sleep disorder and clinical syndromes were determined in 100 patients. The patients were divided into three groups (light, moderate and severe) according to brain injury severity. Analysis of EEG demonstrated that sleep stages of the patients of all groups were structurally changed, namely it took from 30 to 90 minutes (normally 10−20 minutes) for the 1st stage. Superficial sleep (2nd stage) lasted from 40 minutes and more (normally 20 minutes). Shortening of deep sleep (the 3rd and the 4th stages) to 5−10 minutes (normally 10−20 minutes) or its absence (hypnoidal state of patients) was registered in the majority of patients. Shortening of fast sleep or its absence was registered in 70 % of the patients. Transitions of superficial and deep sleep stages to waking state, i.e. waking within sleep, have been registered by EEG in 73 % of the patients. Clinical variant of the 1st sleep stage was presomnia, that of superficial, deep and fast sleep was mild insomnia. In conclusion, mild insomnia with vegetovascular dysfunction and liquor hypertension dominated in all groups. Night sleep structure changed in patients with light craniocerebral trauma more significantly than in those with severe and moderate one. This can be explained by the following: functional and adaptation disorders (particularly sleep disorders) take place in a great extent during light craniocerebral trauma, but in case of severe craniocerebral trauma organic changes are more considerable than functional ones. Investigation of manifestations of sleep disorder is prospective in future since it is necessary to solve problems of not only patients rehabilitation but also of further improving the quality of life in the patients.
Key words: traumatic brain injury, presomnic disorders, intrasomnic disorders, postsomnic disorders.