Yangzhou University, Yangzhou, 225009, Jiangsu Province, China.
Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China.
BMC Neurol. 2024 Oct 14;24(1):388. doi: 10.1186/s12883-024-03895-7.
Excessive daytime sleepiness (EDS) is a common complication of stroke that has a detrimental effect on patients' daily life and functional recovery. The clinical characteristics and risk factors for poststroke EDS may differ between males and females.
A retrospective study based on hospital medical records was conducted on patients with a diagnosis of stroke who participated in polysomnographic monitoring at the Affiliated Hospital of Yangzhou University from February 2022 to May 2024. Baseline data, laboratory test data, polysomnographic data, and related scale scores were retrospectively collected. The Epworth Sleepiness Scale (ESS) score was used to assess EDS after stroke. Binary logistic regression was used to determine the risk factors for daytime sleepiness. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Statistical analysis was performed via IBM SPSS 26.0.
ESS scores were higher in males than in females, whereas females had higher Pittsburgh Sleep Quality Index (PSQI) scores and Hospital Anxiety and Depression Scale (HADS) scores. Male sex and higher depression scores were risk factors for EDS; among male patients, higher anxiety scores were a risk factor for EDS, whereas smoking was a protective factor. Depression, a higher arousal index and a reduced proportion of N3 sleep periods were risk factors for EDS in females.
The characteristics and influencing factors of EDS differ between the sexes in patients with mild and moderate ischaemic stroke. Our study may provide evidence and guidance for clinical diagnosis and treatment. Interventional studies are needed to assess the impact of treating these risk factors in the future.
日间过度嗜睡（EDS）是中风的常见并发症，对患者的日常生活和功能恢复有不利影响。男性和女性中风后 EDS 的临床特征和危险因素可能不同。
本研究为基于医院病历的回顾性研究，纳入 2022 年 2 月至 2024 年 5 月在扬州大学附属医院行多导睡眠监测的诊断为中风的患者。回顾性收集基线资料、实验室检查数据、多导睡眠图数据及相关量表评分，采用 Epworth 嗜睡量表（ESS）评分评估中风后 EDS，采用二元 logistic 回归确定日间嗜睡的危险因素。本研究遵循 Strengthening the Reporting of Observational Studies in Epidemiology（STROBE）指南。采用 IBM SPSS 26.0 进行统计分析。
男性 ESS 评分高于女性，而女性的匹兹堡睡眠质量指数（PSQI）评分和医院焦虑抑郁量表（HADS）评分较高。男性和较高的抑郁评分是 EDS 的危险因素；在男性患者中，较高的焦虑评分是 EDS 的危险因素，而吸烟是保护因素。抑郁、觉醒指数升高和 N3 睡眠期比例减少是女性 EDS 的危险因素。
在轻度和中度缺血性中风患者中，EDS 的特征和影响因素在性别上存在差异。本研究可为临床诊断和治疗提供依据和指导。未来需要进行干预性研究来评估治疗这些危险因素的影响。
