Abstract
Nine subjects who underwent a severe head traumatism with a brainstem dysfunction at the acute stage, were polygraphically recorded at the chronic stage under strict conditions of drug withdrawal and light-dark periods. Two groups of subjects were identified. The first one (5 subjects) showed normal NREM sleep and REM sleep morphologic patterns as well as a partly preserved architecture of sleep. The synchronisation of sleep with dark periods was lost in 4 out of 5 cases. In the second (4 subjects) NREM sleep morphologic patterns were lost and REM sleep was either uncertain or absent in 3 subjects. The synchronisation of sleep with dark periods was lost in 3 out of 4 cases. The morphologic alterations of sleep are connected with different types of encephalic lesions whereas the anomalies of the architecture of sleep and of its synchronisation with dark periods are referred to the numerous endogennous and exogenous stimuli undergone by these subjects. At the chronic stage of post-traumatic comas a 24-hour polygraphic recording supplies no definite information with regards to the prognosis.
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