Investigation on sleep disorders after brain injury and analysis of risk factors

Xin Ru; Rui Ran; Zhu Chengwei

doi:10.11850/j.issn.1009-122X.2025.09.008

Abstract：Objective To explore the risk factors for sleep disorders after brain injury and to establish a predictive model.Methods The clinical data of 240 patients with brain injury were analyzed retrospectively.All the patients were assessed using the Pittsburgh Sleep Quality Index(PSQI).Based on PSQI scores,patients were divided into a sleep disorder group(PSQI>7,n=129)and a non-sleep disorder group(PSQI≤7,n=111).Univariate analysis was performed to compare differences in clinical data between the two groups.Statistically significant indicators were included in logistic regression analysis to identify factors influencing the occurrence of sleep disorders after brain injury and to construct a predictive model.The predictive performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results The incidence of sleep disorders was 53.75%.Logistic regression analysis revealed that age≥50 years,severe brain injury,hemiplegia,severe pain,comorbid diabetes,higher 17-item hamilton depression rating scale(HAMD-17)scores,and higher hamilton anxiety scale(HAMA)scores were significant risk factors for sleep disorders after brain injury(all P<0.05).The Hosmer-Lemeshow test showed good calibration of the predictive model(χ2=0.289,P=0.117).ROC curve analysis demonstrated that the area under the curve(AUC)of the model for predicting sleep disorders after brain injury was 0.848(95%CI:0.763-0.934),with a sensitivity of 81.47%and specificity of 73.63%.Conclusions Multiple factors influence the occurrence of sleep disorders in patients with brain injury.The predictive model constructed based on relevant risk factors exhibits high predictive value,enabling clinicians to promptly identify patients at high risk of sleep disorders and implement appropriate interventions to improve sleep quality in patients with brain injury.