脑卒中部位与睡眠障碍相关性研究进展

Advances in research on the relationship between stroke location and sleep disorders

卒中后睡眠障碍的发生及临床表现与卒中损伤部位有关。脑干卒中导致快速动眼睡眠行为障碍、睡眠呼吸紊乱、不宁腿综合征及睡眠周期性肢动;丘脑卒中多为睡眠增多;下丘脑卒中相关睡眠障碍表现为嗜睡及发作性睡病;额叶皮质卒中引起失眠。觉醒-睡眠周期的调节依赖于皮质和皮质下神经网络解剖和功能的完整性,卒中后睡眠障碍的发生机制主要与不同部位卒中后解剖纤维联系及神经递质功能受损有关,因其影响神经功能改善,应尽早引起临床医生关注。

The occurrence and clinical manifestations of post-stroke sleep disorders are related to the injury site of stroke.Brain stem stroke leads to rapid eye movement sleep behavior disorder,sleep-disordered breathing,restless leg syndrome and periodic limb movement in sleep.Patients with thalamic stroke often show increased sleep.Hypothalamic stroke related sleep disorders manifest as somnolence and narcolepsy.Prefrontal cortical stroke causes insomnia.The regulation of the wake-sleep cycle depends on the anatomical and functional integrity of the cortical and subcortical neural networks.The mechanisms of post-stroke sleep disorders are mainly associated with the destruction of anatomical fibers and impaired neurotransmitter function after stroke in different locations.As post-stroke sleep disorders affect the improvement of neurological function,clinicians should pay attention to this as early as possible.