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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Addition of Suvorexant to Ramelteon Therapy for Improved Sleep Quality with Reduced Delirium Risk in Acute Stroke Patients
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Addition of Suvorexant to Ramelteon Therapy for Improved Sleep Quality with Reduced Delirium Risk in Acute Stroke Patients

机译：添加到Ramelteon疗法的Suvorexant，以改善急性中风患者的谵妄风险降低

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Background and PurposeDelirium in acute stroke is associated with poor clinical outcome. The purpose of this study was to examine the effect of sleep medications on sleep quality and delirium in acute stroke. MethodsIn this retrospective cohort study, sleep disturbances, and delirium were investigated in acute stroke patients treated in April 2013-March 2017 who were prescribed ramelteon plus either an alpha-aminobutyric acid receptor (GABAR) agonist or a selective dual orexin receptor antagonist (suvorexant). ResultsOf the patients included, 104 received a GABAR agonist and 128 received suvorexant in addition to ramelteon. Patient characteristics did not differ significantly between the groups, except for a higher proportion of cerebral infarction in suvorexant group (P?=?.033). Subjective sleep quality was significantly improved in suvorexant group compared to GABAR agonist group (difficulty staying asleep: 6.3% versus 34%,P< .001; daytime sleepiness: 33% versus 63%,P< .001). Delirium was significantly less frequent in suvorexant group than GABAR agonist group (7.0% versus 31%,P< .001). The length of hospital stay was significantly shorter in suvorexant group than in GABAR agonist group (in days, 21 [15-29] versus 25 [18-33];P?=?.019). Multivariable logistic regression analysis revealed that the addition of suvorexant was significantly associated with a reduced occurrence of delirium (odds ratios .19, 95% confidence interval .085-.43,P< .001). ConclusionsAddition of suvorexant to ramelteon therapy, rather than a GABA receptor agonist, can improve subjective sleep quality without inducing delirium in acute stroke patients.
机译：急性中风中的背景和紫外线与临床结果不良有关。本研究的目的是检查睡眠药物对急性中风睡眠质量和谵妄的影响。方法在2013年4月至2017年4月治疗的急性脑卒中患者中研究了该回顾性的队列研究，睡眠障碍和谵妄，该急性中风患者被规定的ramelteon加上α-氨基丁酸受体（GABAR）激动剂或选择性双羊蛋白受体拮抗剂（Suvorexant） 。除了ramelteon之外，包括包括患者的结果，104件接受了GABAR激动剂和128个。患者特征在组之间没有显着差异，除了Suvorexant组中的脑梗死比例较高（P？= 033）。与GABAR激动剂组相比，Suvorexant组在Suvorexant组中显着改善了主观睡眠质量（睡眠困难：6.3％对34％，P <.001;白天嗜睡：33％对63％，P <.001）。谵妄在Suvorexant组中的频率显着低于Gabar激动剂组（7.0％对31％，P <.001）。 Suvorexant组的医院住宿的长度明显较短，而不是GABAR激动剂组（在日期，21 [15-29]与25 [18-33]; p？= 019）。多变量逻辑回归分析显示，加入Suvorexant与谵妄的发生显着相关（差距，95％置信区间.085-.43，P <.001）。结论加入克拉克森治疗，而不是GABA受体激动剂，可以提高主观睡眠质量，不会在急性中风患者中诱导谵妄。

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