Desórdenes de sueño en pacientes con daño cerebral adquirido, factores asociados y su impacto sobre la funcionalidad

Abstract

Objective: To identify the prevalence of sleep disorders in chronic post-stroke and post-traumatic brain injury (TBI) patients, to determine the risk factors and their impact on functionality in activities of daily life. Material and methods: Cross-sectional clinical study that included adults ≥ 18 years with a history of acquired brain damage (post-stroke or post-TBI). Sociodemographic data and clinical history were obtained, and the following instruments were applied: Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Berlin Questionnaire © Sleep Apnea, the Barthel's functionality index, the Hamilton Depression Rating Scale and the Beck Anxiety Inventory. Results: We included 116 patients, 91 post-stroke (78.4%) and 25 post-TBI (21.6%), mean age was 56.58 years (SD = 19.37). In post-stroke patients, the following risk factors were identified: diabetes (OR = 3.01; 95% CI = 1.13-8.01 for poor sleep quality), multiple comorbidities (OR = 3.78; 95% CI = 1.04-13.67 for quality of sleep), depression (OR = 2.46; 95% CI = 2.46-25.80 for apnea; OR = 7.94; 95% CI = 1.25-10.82 for insomnia) and anxiety (OR = 17.84; 95% CI = 2.28-139.64 for insomnia). In post-TBI patients, the following were identified as risk factors: overweight/obesity (OR = 11.25; 95% CI = 1.64-76.84 for poor sleep quality) and coma (OR = 2.33; 95% CI = 1.42-3.82 for sleepiness). The risk factor for functional loss in post-stroke is apnea (OR = 2.63; 95% CI = 1.05-6.54) and in post-TBI the poor quality of sleep (OR = 8.25; 95% CI = 1.15-50.03). Conclusion: Post-stroke and post-TBI patients have a high prevalence of sleep disorders and its comorbidities increase the risk of chronic sleep disorders and functional loss. ResumenObjetivo: Identificar la prevalencia de trastornos en el sueño en pacientes post-stroke y post-TCE, determinar los factores de riesgo y su impacto en la funcionalidad en actividades de la vida diaria. Material y métodos: Estudio clínico transversal que incluyó adultos ≥ de 18 años con antecedente de daño cerebral adquirido (post-stroke o postraumatismo craneoencefálico). Se obtuvieron datos sociodemográficos y antecedentes clínicos, y se aplicaron los siguientes instrumentos: PittsburghSleep Quality Index, the Epworth Sleepiness Scale, the Berlin questionnaire sleep apnea, the Barthel's