School of Nursing, College of Nursing (F.H., H.-C.H., O.F.D.M., H.-Y.C.), Taipei Medical University, Taiwan.
School of Nursing (F.H., B.S.), Politeknik Kesehatan Kemenkes Malang, Indonesia.
Stroke. 2021 Jan;52(2):655-663. doi: 10.1161/STROKEAHA.120.029847. Epub 2021 Jan 7.
The exact prevalence of sleep disorders following stroke or transient ischemic attack (TIA) remains unclear. We aimed to determine the prevalence of sleep-disordered breathing, insomnia, periodic leg movement during sleep, and restless leg syndrome following stroke or TIA in acute, subacute, and chronic phases and examine the moderating effects of patient characteristics (eg, age) and methodological features (eg, study quality) on the prevalence.
We performed a systematic review and meta-analysis. Embase and PubMed were searched from inception to December 18, 2019. We included 64 047 adults in 169 studies (prospective, retrospective, case-control, and cross-sectional study designs) reporting the prevalence of sleep disorders following stroke or TIA.
In the acute phase, the overall prevalence of mild, moderate, and severe sleep-disordered breathing was 66.8%, 50.3%, and 31.6% (95% CIs, 63.8-69.7, 41.9-58.7, and 24.9-39.1). In the subacute phase, the prevalence of mild, moderate, and severe sleep-disordered breathing was 65.5%, 44.3%, and 36.1% (95% CIs, 58.9-71.5, 36.1-52.8, and 22.2-52.8). In the chronic phase, the summary prevalence of mild, moderate, and severe sleep-disordered breathing was 66.2%, 33.1%, and 25.1% (95% CIs, 58.6-73.1, 24.8-42.6, and 10.9-47.6). The prevalence rates of insomnia in the acute, subacute, and chronic phases were 40.7%, 42.6%, and 35.9% (95% CIs, 31.8-50.3, 31.7-54.1, and 28.6-44.0). The pooled prevalence of periodic leg movement during sleep in the acute, subacute, and chronic phases was 32.0%, 27.3%, and 48.2% (95% CIs, 7.4-73.5, 11.6-51.7, and 33.1-63.5). The summary prevalence of restless leg syndrome in the acute and chronic phases was 10.4% and 13.7% (95 CIs, 6.4-16.4 and 2.3-51.8). Age, sex, comorbidities, smoking history, and study region had significant moderating effects on the prevalence of sleep disorders.
Sleep disorders following stroke or TIA are highly prevalent over time. Our findings indicate the importance of early screening and treating sleep disorders following stroke or TIA.
中风或短暂性脑缺血发作（TIA）后睡眠障碍的确切患病率仍不清楚。我们旨在确定中风或 TIA 后在急性、亚急性和慢性阶段睡眠呼吸障碍、失眠、睡眠周期性肢体运动和不宁腿综合征的患病率，并检查患者特征（如年龄）和方法学特征（如研究质量）对患病率的调节作用。
我们进行了系统评价和荟萃分析。从成立到 2019 年 12 月 18 日，在 Embase 和 PubMed 上进行了搜索。我们纳入了 169 项研究中的 64047 名成年人，这些研究报告了中风或 TIA 后睡眠障碍的患病率。
在急性阶段，轻度、中度和重度睡眠呼吸障碍的总体患病率为 66.8%、50.3%和 31.6%（95%CI，63.8-69.7、41.9-58.7 和 24.9-39.1）。在亚急性阶段，轻度、中度和重度睡眠呼吸障碍的患病率分别为 65.5%、44.3%和 36.1%（95%CI，58.9-71.5、36.1-52.8 和 22.2-52.8）。在慢性阶段，轻度、中度和重度睡眠呼吸障碍的综合患病率分别为 66.2%、33.1%和 25.1%（95%CI，58.6-73.1、24.8-42.6 和 10.9-47.6）。急性、亚急性和慢性阶段失眠的患病率分别为 40.7%、42.6%和 35.9%（95%CI，31.8-50.3、31.7-54.1 和 28.6-44.0）。急性、亚急性和慢性阶段睡眠周期性肢体运动的总患病率分别为 32.0%、27.3%和 48.2%（95%CI，7.4-73.5、11.6-51.7 和 33.1-63.5）。急性和慢性阶段不宁腿综合征的总患病率分别为 10.4%和 13.7%（95%CI，6.4-16.4 和 2.3-51.8）。年龄、性别、合并症、吸烟史和研究区域对睡眠障碍的患病率有显著的调节作用。
中风或 TIA 后睡眠障碍的患病率随时间推移而升高。我们的研究结果表明，早期筛查和治疗中风或 TIA 后睡眠障碍的重要性。
