Aim: The aim of our study was to compare characteristics of stroke patients who presented Obstructive Sleep Apnea/Hypopnea (OSAH) to those of cases that presented Central Sleep Apnea/Hypopnea (CSAH) events at PSG, and...Aim: The aim of our study was to compare characteristics of stroke patients who presented Obstructive Sleep Apnea/Hypopnea (OSAH) to those of cases that presented Central Sleep Apnea/Hypopnea (CSAH) events at PSG, and to investigate relationships between the type of breathing disturb during sleep and the location of brain damage. Methods: Thirty four patients were submitted to clinical, neuroradiological and polisomnographyc study (PSG) after 4 months of stroke. A Sleep Disordered Breathing (SDB) was diagnosed in all cases with an AHI > 5. Patients were classified as affected by predominantly OSAH (pOSAH), or predominantly CSAH (pCSAH). Comparisons were made among the groups and correlation analyses were done in each group. Significance was set at p < 0.005. Results: Twenty six patients with ischemic strokes had a SDB during sleep (56% embolic, 31% lacunar, 8% large artery, 8% with undetermined cause). The 61% of them showed pOSAH. Except for age, no statistical differences were found between the two groups as to clinical findings, risk factors for stroke, PSG data, or location of brain lesion. Correlation analysis outlined that in pOSAH cases the time interval from stroke to PSG (Δt) was inversely related to both TST (p = 0.017) and TSP (p = 0.039);in pCSAHs it was inversely related to SE Index (p = 0.021) and directly related to both ODI (p = 0.016) and with the n. of arrhythmias/h sleep (p = 0.033). In pCSAH, AHI did not correlate with ODI. Conclusions: Our data suggest that among cases with post stroke SDB is included 3 different subgroups of cases: OSAHs who terminate the obstruction by arousal, OSAHs who do not arise and alternate obstructive to central events, and CSAHs due to the direct effect of stroke on the breathing network;in a forth subgroup of cases, the microstructure of sleep might be altered, with the consequent occurrence of sleep-related events. Further studies are needed to clarify these hypotheses as well as the role of poststroke depression on the nature and occurrence of SDB after stroke.展开更多
The association between sleep-disordered breathing(SDB) and cardiovascular risk has been the focus of attention in recent years.Sleep disorders are emerging risk factors for cardiovascular disease and have been relate...The association between sleep-disordered breathing(SDB) and cardiovascular risk has been the focus of attention in recent years.Sleep disorders are emerging risk factors for cardiovascular disease and have been related to the whole spectrum of stroke,including transient ischemic attack,ischemic cerebral infarction and intracerebral haemorrhage.It has been shown that lacunar stroke or lacunar infarctions affecting the internal capsule or the protuberance are associated with a higher frequency of SDB.Acute stroke patients with associated SDB have a worse prognosis and a higher mortality as compared to patients with first-ever stroke without SDB.Preliminary studies provide evidence of the usefulness of treatment with continuous positive airway pressure when SDB is present in stroke patients.展开更多
Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic ...Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic database of clinical literature on the treatment of sleep disorders after stroke by TCM from January 2000 to January 2021.Excel was used to establish the database,and the prescription information was described and analyzed statistically.Using IBM SPSS Modeler 18.0 software,Apriori algorithm was used for TCM association analysis,and IBM SPSS 22.0 software was used for systematic cluster analysis of high-frequency TCM.Results:A total of 67 literatures were included,covering 131 traditional Chinese medicines.The medecines with a higher frequency of sodium use include Ziziphi Spinosae Semen(Suanzaoren),Angelicae Sinensis Radix(Danggui),Ligusticum(Chuanxiong),liquorice(Gancao),Poria cocos(Fuling),and so on.From the effect point of view,deficiency-tonifying medicine,sedative medicine and blood-activating and stasis-removing medicine are commonly used.The medicinal properties are mainly cold,mild and warm.The main medicine flavor are sweet and bitter.The medicines mostly belong to the liver,heart and spleen Meridian.Thirty-three association rules were obtained for medicine pairs and medicine groups from the correlation analysis,and the core combinations were"Ziziphi Spinosae Semen(Suanzaoren)-Tuber fleeceflower stem(Yejiaoteng)","Ziziphi Spinosae Semen(Suanzaoren)-Polygala(Yuanzhi)","Ziziphi Spinosae Semen(Suanzaoren)-Cortex albiziae(Hehuanpi)"and"Angelicae Sinensis Radix(Danggui)-Radix bupleuri(Chaihu)-Radix Paeoniae Alba(Baishao)"and so on.Seven medicine aggregation groups were obtained by medicine cluster analysis.Conclusion:In the treatment of sleep disorder after stroke by TCM,the main method is to calm the heart and mind.Meanwhile,according to different syndrome types,the treatment methods of tonifying the heart and spleen,nourishing the liver and kidney,soothing the liver and softening the liver,clearing heat and resolving phlegm,nourishing the blood and promoting blood circulation are selected,which provide certain reference for clinical treatment.展开更多
Stroke is a leading cause of death and disability.Despite expensive and elaborative research in finding out mechanisms of interrelation between sleep-disordered breathing(SDB)and stroke,there is yet much attention to ...Stroke is a leading cause of death and disability.Despite expensive and elaborative research in finding out mechanisms of interrelation between sleep-disordered breathing(SDB)and stroke,there is yet much attention to be given in stroke units worldwide to the prompt diagnosis and treatment of SDB in order to improve morbidity and mortality rates related with stroke.The preventive diagnosis and treatment of SDB reduce stroke rate and improves penumbra area in case of ischemic stroke.Stroke itself predispose to SDB,making the interrelationship more complicated.The review by Parra O and Arboix A reflects the results from carefully selected reviews reported in the literature so far.This review of the literature and presentation of the original study of the Authors based on their patients’data,enhances the conviction that there exists a direct relation between SDB and stroke.Diagnosis of SDB in new stroke cases should be sought and treated carefully whenever present.展开更多
目的采用Meta分析评价正念干预(MBI)对脑卒中患者睡眠障碍的改善效果。方法计算机检索Embase、PubMed、Cochrane Library、Web of Science、CINAHL、中国知网、万方、维普、中国生物医学文献数据库,检索时间为建库至2022年10月31日。依...目的采用Meta分析评价正念干预(MBI)对脑卒中患者睡眠障碍的改善效果。方法计算机检索Embase、PubMed、Cochrane Library、Web of Science、CINAHL、中国知网、万方、维普、中国生物医学文献数据库,检索时间为建库至2022年10月31日。依照纳入和排除标准筛选文献并对纳入文献进行资料提取和质量评价,使用RevMan5.3软件进行Meta分析。结果共纳入12篇文献,1006例患者,其中观察组502例,对照组504例。Meta分析结果显示,观察组的匹兹堡睡眠质量指数(PSQI)评分低于对照组(P<0.00001);合并结果显示,两组的总睡眠时间(TST)、醒觉次数(AT)、醒觉时间(AWT)、睡眠效率(SE)、3期持续睡眠时间(S_(3))、4期持续睡眠时间(S_(4))、非快速眼动睡眠期(NREM)、醒觉时间占总记录时间比例(AR)、总微醒觉次数(MAT)、快速动眼期微醒觉次数(MAT-REM)比较,差异具有统计学意义(P<0.05)。结论MBI可在短期内缓解脑卒中患者睡眠障碍及伴随的焦虑、抑郁等负性情绪,但是能否长期从中获益尚需开展高质量、大样本、多中心随访研究。展开更多
目的分析2013—2023年缺血性卒中和睡眠相关性研究的现状及研究热点。方法在Web of Science核心合集中检索2013年1月1日—2023年12月31日缺血性卒中和睡眠相关性研究的文献。使用RStudio的bibliometrix软件包和VOSviewer软件对该领域研...目的分析2013—2023年缺血性卒中和睡眠相关性研究的现状及研究热点。方法在Web of Science核心合集中检索2013年1月1日—2023年12月31日缺血性卒中和睡眠相关性研究的文献。使用RStudio的bibliometrix软件包和VOSviewer软件对该领域研究的发文量、国家/地区、机构、作者、期刊、文献引用、关键词和研究热点进行分析,并进行可视化呈现。结果共检索到798篇文献。以通信作者分析,中国发文199篇,居全球首位,且与多个国家建立了合作关系。美国发文196篇,位列第2。发文量最多的机构是加拿大多伦多大学,共34篇。发文量前10位的作者中5位来自美国密歇根大学,相互合作较密切,其中美国学者Devin L Brown发表文章数量为28篇,被引频次236次,发文量和被引频次均居首位。发文量最多的期刊是Sleep Medicine(74篇),发表文章被引频次最高的期刊是Stroke(3542次)。关键词可视化分析发现卒中与睡眠呼吸暂停出现频次最高。在卒中与睡眠相关性研究领域,研究主题分析提示失眠、抑郁作为基础课题对该领域发展非常重要,卒中预防、功能结局、脑血流主题研究需要努力开发。结论越来越多的研究聚焦于缺血性卒中和睡眠之间的关联性,中国和美国在该领域发表文献较多,睡眠呼吸障碍是主要研究热点。未来在卒中和睡眠领域可探索失眠、抑郁、卒中预防、功能结局、脑血流等主题。展开更多
文摘Aim: The aim of our study was to compare characteristics of stroke patients who presented Obstructive Sleep Apnea/Hypopnea (OSAH) to those of cases that presented Central Sleep Apnea/Hypopnea (CSAH) events at PSG, and to investigate relationships between the type of breathing disturb during sleep and the location of brain damage. Methods: Thirty four patients were submitted to clinical, neuroradiological and polisomnographyc study (PSG) after 4 months of stroke. A Sleep Disordered Breathing (SDB) was diagnosed in all cases with an AHI > 5. Patients were classified as affected by predominantly OSAH (pOSAH), or predominantly CSAH (pCSAH). Comparisons were made among the groups and correlation analyses were done in each group. Significance was set at p < 0.005. Results: Twenty six patients with ischemic strokes had a SDB during sleep (56% embolic, 31% lacunar, 8% large artery, 8% with undetermined cause). The 61% of them showed pOSAH. Except for age, no statistical differences were found between the two groups as to clinical findings, risk factors for stroke, PSG data, or location of brain lesion. Correlation analysis outlined that in pOSAH cases the time interval from stroke to PSG (Δt) was inversely related to both TST (p = 0.017) and TSP (p = 0.039);in pCSAHs it was inversely related to SE Index (p = 0.021) and directly related to both ODI (p = 0.016) and with the n. of arrhythmias/h sleep (p = 0.033). In pCSAH, AHI did not correlate with ODI. Conclusions: Our data suggest that among cases with post stroke SDB is included 3 different subgroups of cases: OSAHs who terminate the obstruction by arousal, OSAHs who do not arise and alternate obstructive to central events, and CSAHs due to the direct effect of stroke on the breathing network;in a forth subgroup of cases, the microstructure of sleep might be altered, with the consequent occurrence of sleep-related events. Further studies are needed to clarify these hypotheses as well as the role of poststroke depression on the nature and occurrence of SDB after stroke.
文摘The association between sleep-disordered breathing(SDB) and cardiovascular risk has been the focus of attention in recent years.Sleep disorders are emerging risk factors for cardiovascular disease and have been related to the whole spectrum of stroke,including transient ischemic attack,ischemic cerebral infarction and intracerebral haemorrhage.It has been shown that lacunar stroke or lacunar infarctions affecting the internal capsule or the protuberance are associated with a higher frequency of SDB.Acute stroke patients with associated SDB have a worse prognosis and a higher mortality as compared to patients with first-ever stroke without SDB.Preliminary studies provide evidence of the usefulness of treatment with continuous positive airway pressure when SDB is present in stroke patients.
基金Beijing Science and Technology Program(No.Z191100006619065)National Key R&D Program(No.2017YFC1700101)。
文摘Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic database of clinical literature on the treatment of sleep disorders after stroke by TCM from January 2000 to January 2021.Excel was used to establish the database,and the prescription information was described and analyzed statistically.Using IBM SPSS Modeler 18.0 software,Apriori algorithm was used for TCM association analysis,and IBM SPSS 22.0 software was used for systematic cluster analysis of high-frequency TCM.Results:A total of 67 literatures were included,covering 131 traditional Chinese medicines.The medecines with a higher frequency of sodium use include Ziziphi Spinosae Semen(Suanzaoren),Angelicae Sinensis Radix(Danggui),Ligusticum(Chuanxiong),liquorice(Gancao),Poria cocos(Fuling),and so on.From the effect point of view,deficiency-tonifying medicine,sedative medicine and blood-activating and stasis-removing medicine are commonly used.The medicinal properties are mainly cold,mild and warm.The main medicine flavor are sweet and bitter.The medicines mostly belong to the liver,heart and spleen Meridian.Thirty-three association rules were obtained for medicine pairs and medicine groups from the correlation analysis,and the core combinations were"Ziziphi Spinosae Semen(Suanzaoren)-Tuber fleeceflower stem(Yejiaoteng)","Ziziphi Spinosae Semen(Suanzaoren)-Polygala(Yuanzhi)","Ziziphi Spinosae Semen(Suanzaoren)-Cortex albiziae(Hehuanpi)"and"Angelicae Sinensis Radix(Danggui)-Radix bupleuri(Chaihu)-Radix Paeoniae Alba(Baishao)"and so on.Seven medicine aggregation groups were obtained by medicine cluster analysis.Conclusion:In the treatment of sleep disorder after stroke by TCM,the main method is to calm the heart and mind.Meanwhile,according to different syndrome types,the treatment methods of tonifying the heart and spleen,nourishing the liver and kidney,soothing the liver and softening the liver,clearing heat and resolving phlegm,nourishing the blood and promoting blood circulation are selected,which provide certain reference for clinical treatment.
文摘Stroke is a leading cause of death and disability.Despite expensive and elaborative research in finding out mechanisms of interrelation between sleep-disordered breathing(SDB)and stroke,there is yet much attention to be given in stroke units worldwide to the prompt diagnosis and treatment of SDB in order to improve morbidity and mortality rates related with stroke.The preventive diagnosis and treatment of SDB reduce stroke rate and improves penumbra area in case of ischemic stroke.Stroke itself predispose to SDB,making the interrelationship more complicated.The review by Parra O and Arboix A reflects the results from carefully selected reviews reported in the literature so far.This review of the literature and presentation of the original study of the Authors based on their patients’data,enhances the conviction that there exists a direct relation between SDB and stroke.Diagnosis of SDB in new stroke cases should be sought and treated carefully whenever present.
文摘目的采用Meta分析评价正念干预(MBI)对脑卒中患者睡眠障碍的改善效果。方法计算机检索Embase、PubMed、Cochrane Library、Web of Science、CINAHL、中国知网、万方、维普、中国生物医学文献数据库,检索时间为建库至2022年10月31日。依照纳入和排除标准筛选文献并对纳入文献进行资料提取和质量评价,使用RevMan5.3软件进行Meta分析。结果共纳入12篇文献,1006例患者,其中观察组502例,对照组504例。Meta分析结果显示,观察组的匹兹堡睡眠质量指数(PSQI)评分低于对照组(P<0.00001);合并结果显示,两组的总睡眠时间(TST)、醒觉次数(AT)、醒觉时间(AWT)、睡眠效率(SE)、3期持续睡眠时间(S_(3))、4期持续睡眠时间(S_(4))、非快速眼动睡眠期(NREM)、醒觉时间占总记录时间比例(AR)、总微醒觉次数(MAT)、快速动眼期微醒觉次数(MAT-REM)比较,差异具有统计学意义(P<0.05)。结论MBI可在短期内缓解脑卒中患者睡眠障碍及伴随的焦虑、抑郁等负性情绪,但是能否长期从中获益尚需开展高质量、大样本、多中心随访研究。
文摘目的分析2013—2023年缺血性卒中和睡眠相关性研究的现状及研究热点。方法在Web of Science核心合集中检索2013年1月1日—2023年12月31日缺血性卒中和睡眠相关性研究的文献。使用RStudio的bibliometrix软件包和VOSviewer软件对该领域研究的发文量、国家/地区、机构、作者、期刊、文献引用、关键词和研究热点进行分析,并进行可视化呈现。结果共检索到798篇文献。以通信作者分析,中国发文199篇,居全球首位,且与多个国家建立了合作关系。美国发文196篇,位列第2。发文量最多的机构是加拿大多伦多大学,共34篇。发文量前10位的作者中5位来自美国密歇根大学,相互合作较密切,其中美国学者Devin L Brown发表文章数量为28篇,被引频次236次,发文量和被引频次均居首位。发文量最多的期刊是Sleep Medicine(74篇),发表文章被引频次最高的期刊是Stroke(3542次)。关键词可视化分析发现卒中与睡眠呼吸暂停出现频次最高。在卒中与睡眠相关性研究领域,研究主题分析提示失眠、抑郁作为基础课题对该领域发展非常重要,卒中预防、功能结局、脑血流主题研究需要努力开发。结论越来越多的研究聚焦于缺血性卒中和睡眠之间的关联性,中国和美国在该领域发表文献较多,睡眠呼吸障碍是主要研究热点。未来在卒中和睡眠领域可探索失眠、抑郁、卒中预防、功能结局、脑血流等主题。
