Longitudinal mediating effect of autonomic dysfunction on sleep quality and living ability in patients with severe traumatic brain injury
Ji Huining
Fan Chaolin
Zhai Huimin
Han Li
Abstract：Objective To explore the longitudinal mediating effect of autonomic dysfunction on sleep quality and living ability in patients with severe traumatic brain injury(sTBI).Methods A total of 245 sTBI patients undergoing treatment were enrolled.The Simplified Evaluation of Consciousness Disorders(SECONDs),the Chinese version of the Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire(RBDSQ),and the Quality of Life after Brain Injury(QOLIBRI)scale were administered for continuous follow-up over 6 months.Using latent variable growth curve models and longitudinal mediation models,a longitudinal analysis was conducted on the relationships between sleep quality,autonomic dysfunction,and living ability in sTBI patients,and the mediating role of autonomic dysfunction was explored.Results The correlation analysis results showed significant correlations between decreased sleep quality,autonomic dysfunction,and deteriorated living ability in sTBI patients(all P<0.05).The linear latent growth model results indicated that the living ability and autonomic function of sTBI patients showed a declining trend,while decreased sleep quality showed an increasing trend.The latent variable growth curve mediation model revealed that the total effect of the RBDSQ intercept on the QOLIBRI intercept was significant(β=3.453,P=0.006),the indirect effect of the SECONDs intercept between the RBDSQ intercept and the QOLIBRI intercept was significant(β=0.984,P=0.000),and the direct effect of the RBDSQ intercept on the QOLIBRI intercept was significant(β=0.758,P=0.002).The total effect of the RBDSQ slope on the QOLIBRI slope was not significant(β=0.023,P=0.602),the indirect effect of the SECONDs slope between the RBDSQ slope and the QOLIBRI slope was significant(β=0.456,P=0.002),and the direct effect of the RBDSQ slope on the QOLIBRI slope was not significant(β=-0.185,P=0.084).Conclusions There is a close longitudinal association between sleep quality,autonomic dysfunction,and living ability in sTBI patients.Decreased sleep quality can exacerbate the symptoms of autonomic dysfunction,thereby further reducing the patients'living ability.Early and effective intervention for autonomic dysfunction may improve the patients'living ability to a certain extent.
Keywords：brain injurytraumaticseveredysautonomiasrapid eye movement sleep behaviorquality of life
Publication Date：2025-09-20
Online Publishing Date：2025-10-17(First online date of this platform, not the publication date of the document)
Pages：7( 536-542 )