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Evaluation of sleep disorders in children and adolescents after traumatic brain injury
Sleep disorders are highly prevalent after pediatric traumatic brain injury (TBI), regardless of severity, contributing to the development of neurocognitive and behavioral deficits, in addition to a longer recovery period after the trauma. Data on the sleep of children and adolescents after TBI are limited in the literature and, considering the implications of sleep disorders in recovery after trauma, its assessment is essential to improve the outcome of these patients. The Sleep Disorders in Children Scale (SDCS) is an adequate tool for sleep assessment after pediatric TBI, because its application is simple, low-cost and easy to insert into clinical practice for detecting sleep disorders, being adapted for the pediatric population and validated for Brazil.
To identify the incidence of sleep disorders in children and adolescents victims of TBI after the first year of hospital discharge.
Application of the SDSC via telephone or face-to-face in 25 children and adolescents who were admitted with a diagnosis of TBI in the Emergency Unit of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto between May 2019 and May 2020 after the first year of hospital discharge. The SDCS is composed of 26 items that score between 1 and 5 and divided into 6 subscales: disorders of initiating and maintaining sleep (DIMS); sleep breathing disorders (SBD); disorders of arousal / nightmares (DA); sleep-wake transition disturbances (SWTD); disorders of excessive somnolence(DOES) and sleep hyperhydrosis (SHY). Higher scores indicate greater presence and higher frequency of sleep disorders. Data were analyzed according to the total score of the scale and subscales and expressed as median and range.
The median age of sample was 13 years (8 - 18) with male predominance (68%). The median total scale score was 39 (26 - 82). For the subscales the median scores were 10 (7 - 35) for DIMS; 3 (3 - 7) for SBD; 3 (3 - 6) for DA; 10 (7 - 31) for SWTD; 8 (5 - 17) for DOES and 2 (2 - 10) for SHY. The highest frequency of changes was in the item difficulty waking up (64%) and in the subscale DIMS (88%), being present in 24 out of the 25 patients in the sample.
Children and adolescents after TBI present sleep alterations, being more frequent in waking up, sleep onset and sleep maintenance. Sleep monitoring and evaluation are essential for maintaining the quality of life of these patients after pediatric TBI.
sleep, sleep disorders, traumatic brain injury, children, adolescents.
Tabata Luna Garavazzo Tavares, Marina Foresti dos Santos, Guilherme Vargas de Azevedo, Marcell Silva Costa, Ana Paula de Carvalho Panzeri Carlotti, Octávio Marques Pontes-Neto, Alan Luiz Eckeli