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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Obstructive Sleep Apnea and Wake-up Stroke - A 12 Months Prospective Longitudinal Study
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Obstructive Sleep Apnea and Wake-up Stroke - A 12 Months Prospective Longitudinal Study

机译：阻塞性睡眠呼吸暂停和唤醒中风 - 一个12个月的前瞻性纵向研究

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Background: Wake-up stroke (WUS) are strokes that are noted upon awakening in patients previously going to bed in a normal state of health. The role of sleep abnormalities in WUS is uncertain. The objective was to determine clinical characteristics, respiratory abnormalities during sleep and outcomes in patients with WUS versus non-WUS. Methods: At baseline, patients with ischemic stroke were examined clinically and with a portable sleep recorder. Apnea-Hypopnea Index greater than or equal to 20 defined a cut-off severity index. At follow-up (3 and 12-months), patients were re-evaluated clinically and with questionnaires: Epworth Sleepiness Scale, Modified Rankin (MR) and Modified Barthel Index Results: Among all (N = 102, 64% male), hypertension (73%), Type 2 diabetes (29.4), heart disease (16.7%), physical inactivity (69.6%), smoking (32.4%) and alcohol consumption (17.6) were found. Apnea-Hypopnea Index (AHI) greater than 5 (92.9%), AHI greater than 15 (44.7%), AHI greater than or equal to 20 (35.3%) and AHI greater than 30 (11.8%) were registered. Cases with and without WUS did not differ regarding polygraphic findings. Long apneas (apnea duration > 20 s) was equally found in patients with WUS (23.1%) and non-WUS (23.7%). Type 2 diabetes mellitus (T2D) was independently associated with WUS (OR = 2.76; CI: 1.10-6.05; P = .03). Prospectively, symptom severity was not different between WUS and non-WUS. Overall, patients with OSA (IAH >= 20) evolved with worse functional performance (MR, P = .02). Conclusions: Wake-up stroke occurred in approximately 1 of 3 of cases. Irrespective of WUS, half of the patients had moderate to severe sleep apnea; those with OSA (AHI >= 20) evolved with worse functional performance after 1 year. WUS was associated with TDM reinforcing a relationship with cerebral small vessel disease.
机译：背景：唤醒中风（WUS）是指在正常健康状态下入睡的患者在醒来时出现的中风。睡眠异常在WUS中的作用尚不确定。目的是确定WUS患者与非WUS患者的临床特征、睡眠期间的呼吸异常和预后。方法：在基线检查时，对缺血性中风患者进行临床检查，并使用便携式睡眠记录仪。呼吸暂停低通气指数大于或等于20定义了临界严重性指数。在随访（3个月和12个月）时，对患者进行临床和问卷调查：Epworth嗜睡量表、改良Rankin（MR）和改良Barthel指数结果：在所有患者中（N=102，64%为男性）、高血压（73%）、2型糖尿病（29.4%）、心脏病（16.7%）、缺乏运动（69.6%）、吸烟（32.4%）和饮酒（17.6%）。记录的呼吸暂停低通气指数（AHI）大于5（92.9%）、AHI大于15（44.7%）、AHI大于或等于20（35.3%）和AHI大于30（11.8%）。有和没有WUS的病例在多导图检查结果方面没有差异。在WUS患者（23.1%）和非WUS患者（23.7%）中发现长时间呼吸暂停（呼吸暂停持续时间>20秒）。2型糖尿病（T2D）与WUS独立相关（OR=2.76；CI:1.10-6.05；P=0.03）。前瞻性地，WUS和非WUS患者的症状严重程度没有差异。总体而言，OSA患者（IAH>=20）的功能表现较差（MR，P=0.02）。结论：在3例患者中，约有1例出现醒后卒中。不管WUS如何，一半的患者患有中度至重度睡眠呼吸暂停；OSA患者（AHI>=20）在1年后功能表现更差。WUS与TDM相关，加强了与脑小血管疾病的关系。

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