a Michigan Medicine Stroke Program , Cardiovascular Center , Ann Arbor , MI , USA.
b Michigan Medicine , Michael S. Aldrich Sleep Disorders Laboratory , Ann Arbor , MI , USA.
Expert Rev Neurother. 2018 Jul;18(7):523-531. doi: 10.1080/14737175.2018.1489239. Epub 2018 Jun 25.
Stroke is a major cause of disability and death in the United States and across the world, and the incidence and prevalence of stroke are expected to rise significantly due to an aging population. Obstructive sleep apnea, an established independent risk factor for stroke, is a highly prevalent disease that is estimated to double the risk of stroke. It remains uncertain whether non-apnea sleep disorders increase the risk of stroke. Areas covered: This paper reviews the literature describing the association between incident stroke and sleep apnea, rapid eye movement sleep behavior disorder, restless legs syndrome, periodic limb movements of sleep, insomnia, and shift work. Expert commentary: Trials of continuous positive airway pressure for stroke prevention in sleep apnea patients have been largely disappointing, but additional trials that target populations not yet optimally studied are needed. Self-reported short and long sleep duration may be associated with incident stroke. However, abnormal sleep duration may be a marker of chronic disease, which may itself be associated with incident stroke. The relationship between non-apnea sleep disorders and incident stroke deserves further attention. Identification of specific non-apnea sleep disorders or sleep problems that convey an increased risk for stroke may provide novel targets for stroke prevention.
中风是美国和全球范围内导致残疾和死亡的主要原因，由于人口老龄化，中风的发病率和患病率预计将显著上升。阻塞性睡眠呼吸暂停是中风的一个既定独立危险因素，是一种高发疾病，估计会使中风的风险增加一倍。目前尚不确定非呼吸暂停性睡眠障碍是否会增加中风的风险。
本文综述了描述中风与睡眠呼吸暂停、快速眼动睡眠行为障碍、不安腿综合征、睡眠周期性肢体运动、失眠和轮班工作之间关联的文献。
针对睡眠呼吸暂停患者进行的预防中风的持续气道正压通气试验结果大多令人失望，但需要针对尚未得到充分研究的人群进行更多的试验。自我报告的短时间和长时间睡眠与中风的发生可能相关。然而，异常的睡眠时间可能是慢性疾病的一个标志，而慢性疾病本身可能与中风的发生有关。非呼吸暂停性睡眠障碍与中风之间的关系值得进一步关注。确定特定的非呼吸暂停性睡眠障碍或睡眠问题是否会增加中风的风险，可能为中风预防提供新的目标。
