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Review article
DOI: 10.1016/j.neucie.2020.12.001
Available online 30 December 2020
Sleep disorders in traumatic brain injury
Trastornos del sueño en el traumatismo craneoencefálico
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Igor Paredesa,
Corresponding author
, Blanca Navarrob, Alfonso Lagaresa
a Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Neurocirugía, Neuropsicología Clínica, Hospital Universitario 12 de Octubre, Madrid, Spain
Received 16 May 2020. Accepted 03 September 2020
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Table 1. Frequency of sleep disorders in the general population, compared to patients after a TBI.
Table 2. Table summarising TBI-related sleep disorders and their diagnostic/therapeutic management.
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Abstract

The purpose of the review is to collect the most relevant current literature on the mechanisms of normal sleep and sleep disorders associated with traumatic brain injury (TBI), to discuss the most frequent conditions and the evidence on their possible treatments and future research.

Sleep disorders are extremely prevalent after TBI (30-84%). Insomnia and circadian rhythm disorders are the most frequent disorders among the population that has suffered mild TBI, while hypersomnolence disorders are more frequent in populations that have suffered moderate and severe TBI. The syndrome of obstructive sleep apnea and restless leg syndrome are also very frequent in these patients; and patients exposed to multiple TBIs (war veterans) are especially susceptible to sleep disorders. The treatment of these disorders requires taking into account the particularities of these patients.

In conclusion, diagnosis and treatment of sleep disorders should become part of routine clinical practice and cease to be anecdotal (as it is today) in patients with TBI. In addition, it is necessary to continue carrying out research that reveals the best therapeutic approach to these patients.

Keywords:
Traumatic brain injury
Sleep disorder
Hypersomnolence
Insomnia
Sleep anatomy
Hypocretines.
Resumen

El propósito de la revisión es recopilar la literatura actual mas relevante sobre los mecanismos de sueño normal y los trastornos del sueño asociados al traumatismo craneoencefálico (TCE), discutir las afecciones mas frecuentes y la evidencia sobre sus posibles tratamientos y futuras investigaciones.

Los trastornos del sueño son extremadamente prevalentes tras un TCE (30-84%). El insomnio y los trastornos del ritmo circadiano son los trastornos mas frecuentes entre la población que ha sufrido TCE leve, mientras que los trastornos por hipersomnia son mas frecuentes en poblaciones que han sufrido TCE moderado y grave. El síndrome de apneas obstructivas del sueño y el síndrome de piernas inquietas son también muy frecuentes en estos pacientes; y los pacientes expuestos a múltiples TCEs (veteranos de guerra) son especialmente susceptibles a sufrir trastornos del sueño. El tratamiento de estos trastornos requiere tener en cuenta las particularidades de estos pacientes.

Como conclusión, el diagnóstico y tratamiento de los trastornos del sueño debería convertirse en parte de la práctica clínica habitual, y dejar de ser anecdótico (como es hoy en día) en pacientes con TCE. Además, es necesario continuar realizando investigación que nos revele cuál es la mejor aproximación terapéutica a estos pacientes.

Palabras clave:
Traumatismo craneoencefálico
Trastorno del sueño
Hipersomnia
Insomnio
Anatomia del sueño
Hipocretinas.

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