对急性脑梗死(ACI)伴睡眠呼吸障碍(SDB)患者昼夜节律和睡眠状态的研究有限。本研究旨在为脑卒中相关SDB患者的个体化诊治提供科学依据。SC-500睡眠监测器用于连续监测1367名ACI患者5天。根据呼吸暂停低通气指数(AHI),患者分为非SDB组(正常)和SDB组(轻度,中度,严重,波动)。通过心率监测计算每日稳定性(IS)和每日变异性(IV),和睡眠状态及其相关性进行了分析。与非SDB组相比,伴有SDB的中度至重度ACI患者表现出IS降低,增加IV,和睡眠碎片。总睡眠时间(TST)差异有统计学意义,快速眼动延迟(REML),睡眠效率(SE),非快速眼动阶段1-2(NREM阶段1-2),非快速眼动阶段3-4(NREM阶段3-4),非快速眼动比例(NREM%),睡眠发作后醒来(WASO),SDB组和非SDB组之间的觉醒次数(NOA)(P<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)呈正相关,REML,NREM阶段1-2,NREM%,快速眼动比例(REM%),WASO,下床时间(TOB),和NOA,与TST呈负相关,SE,NREM阶段3-4,和快速眼动(REM),均有统计学意义(P<0.05)。有和没有SDB的患者之间的简易精神状态检查(MMSE)存在显着统计学差异,在温和的,中度,严重,波动组(P<0.05)。伴有SDB的中度至重度ACI患者更有可能经历昼夜节律和睡眠状态的变化,进而影响认知功能。
■在线版本包含补充材料,可在10.1007/s41105-024-00516-1获得。
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 (P < 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 (P < 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 (P < 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.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s41105-024-00516-1.