慢性中风患者的睡眠与认知功能：一项比较性横断面研究。

Sleep and cognitive function in chronic stroke: a comparative cross-sectional study.

机构信息

University of British Columbia, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health and Centre for Hip Health and Mobility, Vancouver, BC, Canada.

University of British Columbia-Okanagan Campus, Faculty of Management, Kelowna, BC, Canada.

出版信息

Sleep. 2019 May 1;42(5). doi: 10.1093/sleep/zsz040.

DOI:10.1093/sleep/zsz040

PMID:30805652

Abstract

Poor sleep is common following stroke, limits stroke recovery, and can contribute to further cognitive decline post-stroke. However, it is unclear what aspects of sleep are different in older adults with stroke compared with those without, and whether the relationship between sleep and cognitive function differs by stroke history. We investigated whether older adults with stroke experience poorer sleep quality than older adults without stroke, and whether poor sleep quality attenuates cognitive performance among older adults with a history of stroke. Thirty-five age- and sex-matched older adults with stroke (age: 69.86 ± 1.13 years; 51.43% female) and without stroke (age: 69.83 ± 1.12; 51.43% female) were compared with respect to sleep quality using the MotionWatch8 (MW8) and Pittsburgh Sleep Quality Index (PSQI). Cognitive performance was indexed using the Alzheimer's Disease Assessment Scale Plus (ADAS-Cog Plus). Additionally, we examined whether poor sleep quality is associated with poorer cognitive performance among older adults with stroke. Older adults with stroke had longer MW8 measured sleep duration (27.82 ± 12.17 min; p = 0.03) and greater fragmentation (6.44 ± 2.24; p < 0.01), but did not differ in PSQI from their nonstroke peers. There was a significant group x sleep quality interaction for fragmentation (β = 0.02; p < 0.01) and efficiency (β = -0.03; p = 0.02) on ADAS-Cog Plus performance, whereby differences in cognitive performance between older adults with and without stroke were accentuated in the presence of poor sleep quality. Older adults with stroke have poorer sleep quality than their nonstroke counterparts, and older adults with stroke and poor sleep quality experience larger deficits in cognitive performance. Clinical Trial Registration: Vitality: Promoting Cognitive Function in Older Adults With Chronic Stroke (Vitality); https://clinicaltrials.gov/ct2/show/NCT01916486; NCT01916486.

摘要

睡眠质量差在中风后很常见，限制了中风的恢复，并可能导致中风后认知能力进一步下降。然而，目前尚不清楚中风患者的睡眠与无中风患者的睡眠有何不同，以及睡眠与认知功能之间的关系是否因中风史而有所不同。我们调查了中风患者的睡眠质量是否比无中风患者差，以及睡眠质量差是否会削弱中风患者的认知表现。35 名年龄和性别匹配的中风老年人（年龄：69.86 ± 1.13 岁；51.43%为女性）和无中风老年人（年龄：69.83 ± 1.12 岁；51.43%为女性）被比较了睡眠质量，使用 MotionWatch8（MW8）和匹兹堡睡眠质量指数（PSQI）。认知表现的指标是阿尔茨海默病评估量表加（ADAS-Cog Plus）。此外，我们还研究了睡眠质量差是否与中风患者的认知表现较差有关。中风患者的 MW8 测量睡眠时间更长（27.82 ± 12.17 分钟；p = 0.03），碎片化程度更高（6.44 ± 2.24；p < 0.01），但 PSQI 与非中风同龄人无差异。在 ADAS-Cog Plus 表现方面，碎片化（β=0.02；p < 0.01）和效率（β=-0.03；p = 0.02）存在显著的组 x 睡眠质量交互作用，这表明中风患者和非中风患者之间的认知表现差异在睡眠质量差的情况下更加明显。中风患者的睡眠质量比非中风患者差，睡眠质量差的中风患者的认知表现更差。