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急性脑梗死伴睡眠呼吸障碍患者昼夜节律及睡眠状态特征研究

Study on the circadian rhythm and sleep state characteristics of patients with acute cerebral infarction accompanied by sleep-breathing disorders.

作者信息

Wang Lianhui, Yuan Xiaodong, Ou Ya, Xue Jing, Ma Qian, Fu Yongshan, Zhang Pingshu

机构信息

Hebei North College, Zhangjiakou, 075000 Hebei China.

Neurology Department, Kailuan General Hospital, Tangshan, 063000 Hebei China.

出版信息

Sleep Biol Rhythms. 2024 Mar 15;22(3):353-362. doi: 10.1007/s41105-024-00516-1. eCollection 2024 Jul.

Abstract

UNLABELLED

There is limited research on the circadian rhythm and sleep state in patients with acute cerebral infarction (ACI) accompanied by sleep-breathing disorders (SDB). This study aims to provide a scientific basis for individualized diagnosis and treatment for stroke-related SDB patients. The SC-500 sleep monitor was used to continuously monitor 1367 ACI patients over 5 days. Based on the apnea-hypopnea index (AHI), patients were divided into non-SDB group (normal) and SDB group (mild, moderate, severe, fluctuating). Interdaily stability (IS) and intradaily variability (IV) were calculated through heart rate monitoring, and sleep states and their correlations were analyzed. Compared to the non-SDB group, patients with moderate-to-severe ACI accompanied by SDB showed decreased IS, increased IV, and sleep fragmentation. Significant statistical differences were observed in total sleep time (TST), rapid eye movement latency (REML), sleep efficiency (SE), non-rapid eye movement stages 1-2 (NREM stages1-2), non-rapid eye movement stages 3-4 (NREM stages 3-4), proportion of non-rapid eye movement (NREM%), wake after sleep onset (WASO), and number of awakenings (NOA) between the SDB group and the non-SDB group ( < 0.05). AHI showed a strong negative correlation with IS and a strong positive correlation with IV. AHI was positively correlated with sleep latency (SL), REML, NREM stages1-2, NREM%, proportion of rapid eye movement (REM%), WASO, time out of bed (TOB), and NOA, and negatively correlated with TST, SE, NREM stages 3-4, and rapid eye movement (REM), all with statistical significance ( < 0.05). There were significant statistical differences in the Mini-Mental State Examination (MMSE) between patients with and without SDB, and among mild, moderate, severe, and fluctuating groups ( < 0.05). Patients with moderate-to-severe ACI accompanied by SDB are more likely to experience changes in circadian rhythm and sleep states, which in turn affect cognitive functions.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s41105-024-00516-1.

摘要

未标注

关于伴有睡眠呼吸障碍(SDB)的急性脑梗死(ACI)患者的昼夜节律和睡眠状态的研究有限。本研究旨在为中风相关SDB患者的个体化诊断和治疗提供科学依据。使用SC - 500睡眠监测仪对1367例ACI患者进行了为期5天的连续监测。根据呼吸暂停低通气指数(AHI),将患者分为非SDB组(正常)和SDB组(轻度、中度、重度、波动型)。通过心率监测计算日间稳定性(IS)和日内变异性(IV),并分析睡眠状态及其相关性。与非SDB组相比,伴有SDB的中度至重度ACI患者的IS降低、IV增加且睡眠碎片化。SDB组和非SDB组在总睡眠时间(TST)、快速眼动潜伏期(REML)、睡眠效率(SE)、非快速眼动1 - 2期(NREM 1 - 2期)、非快速眼动3 - 4期(NREM 3 - 4期)、非快速眼动比例(NREM%)、睡眠起始后觉醒(WASO)和觉醒次数(NOA)方面存在显著统计学差异(<0.05)。AHI与IS呈强负相关,与IV呈强正相关。AHI与睡眠潜伏期(SL)、REML、NREM 1 - 2期、NREM%、快速眼动比例(REM%)、WASO、起床时间(TOB)和NOA呈正相关,与TST、SE、NREM 3 - 4期和快速眼动(REM)呈负相关,均具有统计学意义(<0.05)。有SDB和无SDB的患者之间以及轻度、中度、重度和波动型组之间在简易精神状态检查表(MMSE)方面存在显著统计学差异(<0.05)。伴有SDB的中度至重度ACI患者更易出现昼夜节律和睡眠状态的变化,进而影响认知功能。

补充信息

在线版本包含可在10.1007/s41105 - 024 - 00516 - 1获取的补充材料。

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