Center for Sleep Medicine, Division of Pulmonary, Sleep and Critical Care Medicine, Mayo Clinic, Rochester, MN 55901, USA.
Postgrad Med. 2010 Nov;122(6):145-53. doi: 10.3810/pgm.2010.11.2232.
Although sleep appears to be a quiescent, passive state externally, there are a multitude of physiological changes occurring during sleep that can affect cerebral homeostasis and predispose individuals to cerebrovascular disorders. Therefore, it is not surprising that sleep-disordered breathing causes significant nocturnal perturbations, such as obstructive sleep apnea (OSA), that can lead to cerebrovascular disorders. There is evidence to suggest that OSA is a risk factor for stroke, although studies have not been able to clearly discern the absence or presence of OSA before the stroke event. Sleep-disordered breathing, such as OSA and central sleep apnea, can occur as a consequence of stroke. Fortunately, treating OSA appears to decrease morbidity and possibly mortality. Unfortunately, continuous positive airway pressure compliance in this population group is low, and significant efforts and resources may be needed to improve compliance and adherence. Various other sleep disorders, such as insomnia, fatigue, hypersomnia, and parasomnia, can occur following a stroke, and physicians treating patients following a stroke need to be aware of these disorders in order to effectively treat such patients.
尽管睡眠在外部看起来是一种静止、被动的状态，但在睡眠过程中会发生许多生理变化，这些变化会影响大脑的内稳态，并使个体易患脑血管疾病。因此，睡眠呼吸障碍会导致显著的夜间紊乱，如阻塞性睡眠呼吸暂停（OSA），这可能导致脑血管疾病，这并不奇怪。有证据表明，OSA 是中风的一个危险因素，尽管研究还未能清楚地区分中风事件发生前是否存在 OSA。睡眠呼吸障碍，如 OSA 和中枢性睡眠呼吸暂停，可能是中风的结果。幸运的是，治疗 OSA 似乎可以降低发病率，可能还可以降低死亡率。不幸的是，该人群组的持续气道正压通气依从性较低，可能需要付出巨大的努力和资源来提高依从性和坚持性。中风后还可能出现各种其他睡眠障碍，如失眠、疲劳、嗜睡和睡眠行为障碍，治疗中风患者的医生需要了解这些障碍，以便有效地治疗此类患者。
