在中风患者中,嗜睡,疲劳和阻塞性睡眠呼吸暂停
Jeppe Suusgaard1, Anders Sode West2, Rune Frandsen1
1Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Denmark.
概括
持续的正气道压力 (CPAP) 治疗的高度坚持显著减少了中风患者与阻塞性睡眠呼吸暂停 (OSA) 的嗜睡. 然而,CPAP没有影响疲劳水平,这强调了需要在中风后进行OSA查的必要性.
科学领域:
- 神经学 神经学
- 睡眠医学 睡眠医学
- 心血管研究研究心血管研究
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 影响了绝大多数中风患者,导致白天的嗜睡和疲劳.
- 系统性查OSA及其对中风后疲劳的影响并不是标准的临床实践.
- 已知持续正气道压力 (CPAP) 可以缓解嗜睡,但它对OSA中风幸存者的疲劳的影响需要进一步调查.
研究的目的:
- 研究CPAP治疗对患有缺血性中风或暂时缺血性发作 (TIA) 和OSA的患者的嗜睡和疲劳的影响.
- 分析CPAP遵守水平与嗜睡和疲劳的变化之间的关系.
主要方法:
- 一项前性,多中心的队列研究选的缺血性中风和TIA患者的OSA使用呼吸透析.
- 符合CPAP条件的患者 (呼吸暂停-呼吸暂停指数≥15) 在基线和中风后7-8个月被评估为嗜睡 (爱普沃思嗜睡量表) 和疲劳 (视觉模拟量表-疲劳).
- 患者被分为高 (≥70%),中度 (50-69%) 和低 (<50%) 的CPAP合规组;Poisson回归分析了差异.
主要成果:
- 在1518名查患者中,648人有资格接受CPAP;333人在随访时被评估.
- 高CPAP遵守与低遵守相比 (p < 0.001) 与睡眠减少有显著的关联.
- 所有合规组的疲劳水平都下降了,没有发现它们之间的显著差异.
结论:
- 在患有OSA的中风后/TIA患者中,高CPAP遵守率有效降低了嗜睡.
- 在这个队列中,CPAP治疗没有显著影响疲劳水平.
- 建议对中风幸存者进行系统的OSA查和促进CPAP的坚持,以控制嗜睡.
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