Association between inertial sleep-wake pattern and the short-term prognosis of acute ischemic stroke
10.19845/j.cnki.zfysjjbzz.2024.0153
- VernacularTitle:惯性睡眠-觉醒模式与急性缺血性脑卒中短期预后关系的研究
- Author:
Xin JIN
1
;
Kun CHEN
;
Yunxia XU
Author Information
1. 海军军医大学第二附属医院神经内科,上海 200003
- Keywords:
Acute ischemic stroke;
Sleep-wake pattern;
Circadian rhythm;
90-day prognosis
- From:
Journal of Apoplexy and Nervous Diseases
2024;41(9):799-805
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of inertial sleep-wake pattern on neurological function,cognition,and emotion in patients with acute ischemic stroke on day 90 after disease onset.Methods The patients with acute isch-emic stroke who were admitted to Department of Neurology in the Second Affiliated Hospital of Navy Medical University from April 2021 to April 2023 were analyzed,and they were divided into groups according to the circadian rhythm of inertial sleep-wake before disease onset.Demographic data,location of lesion,risk factors,and 90-day outcome were recorded and compared between groups.Results A total of 51 patients,aged 30 to 68 years,were enrolled in this study,with a mean age of(47.750±9.104)years.There were 40 male patients(78.43%),with a male/female ratio of 3.64∶1.Among the 51 patients,there were 9 patients(17.65%)with definitely evening type,18(35.29%)with mild evening type,22(43.14%)with intermediate type,and 2(3.92%)with mild morning type,and there were no patients with absolute morning type.There were no significant differences in baseline data between groups(P>0.05);the univariate analysis showed significant differences between groups in 90-day Mini-Mental State Examination(MMSE)score(P=0.021)and Hamilton Anxiety Scale(HAMA)score(P=0.008),and comparison between any two groups showed that the differences mainly came from absolute evening type and intermediate type.The Spearman correlation analysis showed that cognitive function(r=0.492,P<0.001)and anxiety(r=-0.428,P=0.002)on day 90 after the onset of acute stroke were signifi-cantly associated with sleep-wake pattern.The multivariate analysis showed that sleep-wake pattern(P=0.018)and MMSE score on day 14 after disease onset(P=0.001)were independent risk factors for cognitive decline on day 90 in acute ischemic stroke,and sleep-wake pattern(P=0.040)and HAMA score on day 14 after disease onset(P<0.001)were independent influencing factors for anxiety disorder on day 90.Conclusion Inertial sleep-wake pattern is an inde-pendent risk factor for the poor short-term prognosis of cognitive and anxiety outcomes in acute ischemic stroke,and it is recommended to adopt active intervention measures.
