Zhang Pingshu, Wang Lianhui, Xue Jing, Ou Ya, Ma Qian, Fu Yongshan, Yuan Xiaodong
Department of Neurology of Kailuan General Hospital affiliated North China University of Science and Technology, Tangshan City, Hebei Province, China.
Hebei Provincial Key Laboratory of Neurobiological Function, Tangshan City, Hebei Province, China.
Sci Rep. 2025 May 16;15(1):16996. doi: 10.1038/s41598-025-01619-6.
To investigate the changes in sleep architecture in patients with acute ischemic stroke (AIS) accompanied by sleep-disordered breathing (SDB), providing a basis for clinical treatment strategies. 1367 patients with acute ischemic stroke within 48 h of onset who were hospitalized in the Department of Neurology of Kailuan General Hospital from November 2020 to December 2022 were selected. Among them, 963 cases were male and 404 cases were female, age: 33-92 (66.12 ± 10.62) years old.From the start of hospitalization, patients were monitored for 5 consecutive days using the intelligent mattress type sleep monitoring platform system (IMTSMPS). From day 1 to day 5, there was a difference in non-rapid eye movement 3 (NREM3) sleep (min) day two, and day five compared to day one in the ACI without SDB group (p = 0.019), and rapid eye movement (REM) sleep (min) day three compared to day five in the ACI with SDB group (p = 0.001). TST (min), SL (min), WASO (min), TOB (min), NOA (min), HRV1, fluctuated between 5 d in mild SDB group (p < 0.05). SL (min), TOB (min), NOA (min), and HAV1(%) in the moderate SDB group, with fluctuations between 5 d (P < 0.05). TST (min), SL (min), REML(min), NREM3 (min), REM (min), proportion of REM sleep(%), TOB (min), NOA (min)in severe SDB group, there were fluctuations between 5 d (P < 0.05). SDB is one of the most common concomitant symptoms in AIS patients and is closely associated with multiple forms of altered sleep structure. AIS patients without SDB mainly showed changes in NREM3 sleep structure. AIS and SDB patients mainly showed changes in the structure of REM sleep. Different levels of SDB in AIS patients lead to different forms of structural changes in sleep.
探讨急性缺血性卒中（AIS）合并睡眠呼吸障碍（SDB）患者的睡眠结构变化，为临床治疗策略提供依据。选取2020年11月至2022年12月在开滦总医院神经内科住院的发病48小时内的1367例急性缺血性卒中患者。其中，男性963例，女性404例，年龄：33 - 92（66.12±10.62）岁。从住院开始，使用智能床垫式睡眠监测平台系统（IMTSMPS）对患者进行连续5天的监测。在无SDB的急性脑梗死（ACI）组中，从第1天到第5天，第2天和第5天的非快速眼动3（NREM3）睡眠（分钟）与第1天相比有差异（p = 0.019），在有SDB的ACI组中，第3天的快速眼动（REM）睡眠（分钟）与第5天相比有差异（p = 0.001）。轻度SDB组的总睡眠时间（TST，分钟）、睡眠潜伏期（SL，分钟）、觉醒时间（WASO，分钟）、总睡眠时间百分比（TOB，分钟）、非快速眼动睡眠1期百分比（NOA，分钟）、心率变异性1（HRV1）在5天内有波动（p < 0.05）。中度SDB组的SL（分钟）、TOB（分钟）、NOA（分钟）和高频成分占比1（HAV1，%）在5天内有波动（P < 0.05）。重度SDB组的TST（分钟）、SL（分钟）、快速眼动睡眠潜伏期（REML，分钟）、NREM3（分钟）、REM（分钟）、快速眼动睡眠比例（%）、TOB（分钟）、NOA（分钟）在5天内有波动（P < 0.05）。SDB是AIS患者最常见的伴随症状之一，与多种睡眠结构改变形式密切相关。无SDB的AIS患者主要表现为NREM3睡眠结构的改变。AIS合并SDB患者主要表现为REM睡眠结构的改变。AIS患者不同程度的SDB导致不同形式的睡眠结构改变。
