Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, 100069, China.
Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Beijing, 100069, China.
Front Med. 2021 Dec;15(6):867-876. doi: 10.1007/s11684-021-0887-9. Epub 2021 Nov 23.
Sleep disturbances are common in patients with stroke, and sleep quality has a critical role in the onset and outcome of stroke. Poor sleep exacerbates neurological injury, impedes nerve regeneration, and elicits serious complications. Thus, exploring a therapy suitable for patients with stroke and sleep disturbances is imperative. As a multi-targeted nonpharmacological intervention, remote ischemic conditioning can reduce the ischemic size of the brain, improve the functional outcome of stroke, and increase sleep duration. Preclinical/clinical evidence showed that this method can inhibit the inflammatory response, mediate the signal transductions of adenosine, activate the efferents of the vagal nerve, and reset the circadian clocks, all of which are involved in sleep regulation. In particular, cytokines tumor necrosis factor α (TNFα) and adenosine are sleep factors, and electrical vagal nerve stimulation can improve insomnia. On the basis of the common mechanisms of remote ischemic conditioning and sleep regulation, a causal relationship was proposed between remote ischemic conditioning and post-stroke sleep quality.
睡眠障碍在脑卒中患者中很常见，而睡眠质量在脑卒中的发生和转归中起着关键作用。睡眠质量差会加重神经损伤、阻碍神经再生，并引发严重的并发症。因此，探索一种适合脑卒中伴睡眠障碍患者的治疗方法迫在眉睫。作为一种多靶点的非药物干预措施，远程缺血预处理可以减少脑缺血面积，改善脑卒中的功能预后，并增加睡眠时间。临床前/临床证据表明，这种方法可以抑制炎症反应，介导腺苷的信号转导，激活迷走神经传出，重置生物钟，所有这些都与睡眠调节有关。特别是细胞因子肿瘤坏死因子-α（TNFα）和腺苷是睡眠因子，电刺激迷走神经可以改善失眠。基于远程缺血预处理和睡眠调节的共同机制，提出了远程缺血预处理与脑卒中后睡眠质量之间的因果关系。
