Tesis

Insomnia Pascatrauma Kepala dan Faktor yang Berhubungan = Insomnia After Traumatic Brain Injury and Related Factors.

Latar belakang : Insomnia merupakan gangguan tidur yang sering dialami pascatrauma kepala, tetapi faktor yang berhubungan dengan insomnia belum banyak diketahui. Penelitian ini bertujuan mengetahui prevalensi insomnia pascatrauma kepala dan faktor yang berhubungan. Metode penelitian: Desain penelitian potong lintang deskriptif menggunakan Pittsburgh Sleep Quality Index (PSQI) versi Bahasa Indonesia pada pasien pascatrauma kepala di Poliklinik Neurologi RSUPN Ciptomangunkusumo, RSUD Pasar Rebo dan RSPAD Gatot Soebroto selama bulan Maret-Mei 2016 dengan onset minimal tiga bulan. Faktor yang dianalisis adalah derajat keparahan trauma kepala, gambaran CT-Scan kepala, derajat nyeri kepala, gangguan depresi dan ansietas. Derajat keparahan trauma kepala dinilai berdasarkan skala koma Glasgow, lamanya pingsan, lamanya amnesia pascatrauma dan CT-Scan kepala. Insomnia ditetapkan jika skor PSQI >8. Nyeri kepala dinilai dengan numeric rating scale, gangguan depresi dan ansietas dinilai dengan Mini Internasional Neuropsychiatric Interview Version ICD-10 (MINI ICD-10). Hasil : Diantara 70 orang subjek pascatrauma kepala, didapatkan prevalensi insomnia sebesar 33%. Subjek cedera kepala berat (31%) memiliki risiko 3,4 kali mengalami insomnia dibandingkan cedera kepala ringan (42%) (IK 95% 1,072-10,806). Subjek dengan nyeri kepala sedang sampai berat (26%) memiliki risiko 5,78 kali mengalami insomnia dibandingkan subjek tanpa nyeri sampai nyeri kepala ringan (74%) (IK 95% 1,730-19,315). Tidak didapatkan hubungan antara gangguan depresi (9%), ansietas (3%) dengan insomnia. Kesimpulan : Insomnia banyak dijumpai pascatrauma kepala. Keluhan nyeri kepala sedang sampai berat, dan cedera kepala berat merupakan faktor yang berhubungan dengan insomnia.
Kata kunci : insomnia; trauma kepala; gangguan tidur pascatrauma kepala



Background : Insomnia is very common following traumatic brain injury (TBI), but the related factors with insomnia is less known. This study was aimed to determine the prevalence of insomnia after TBI and related factors. Methods : Cross-sectional descriptive study using Pittsburgh Sleep Quality Index (PSQI) Indonesian version on patients with history of TBI, with a minimum of three months since onset, in Neurology clinic of Cipto Mangunkusumo general hospital, Pasar Rebo general hospital and Gatot Soebroto Army hospital during March-May 2016. The analyzed factors consisted of: severity of TBI, head CT-Scan findings, severity of headache, depression, and anxiety disorders. Severity of TBI was assessed on Glasgow coma scale, duration of loss of consciousness, duration of post traumatic amnesia and head CT-Scan findings. Insomnia was determined if PSQI score > 8. Severity of headache was measured by numeric rating scale, depression and anxiety disorders were assessed based on Mini Internasional Neuropsychiatric Interview Version ICD-10 (MINI ICD-10). Results : Prevalence of insomnia among 70 subjects after TBI was 33%. Severe TBI subjects (31%) had 3.4 times the chance of developing insomnia compared to mild cases (42%) (CI 95% 1.072-10.806). Moderate-severe headache subjects (26%) had 5.78 times the risk of having insomnia compared to no headache-mild headache cases (74%) (CI 95% 1.730-19.315). No significant relation could be established between depression (9%), anxiety disorders (3%) with insomnia. Conclusion : Insomnia is common after TBI. Moderate-severe headache and severe TBI are the related factors of insomnia.
Keyword(s): insomnia; traumatic brain injury; post-TBI sleep disorders