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Xu H, Li W, Chen J, Zhang P, Rong S, Tian J, Zhang Y, Li Y, Cui Z, Zhang Y. Associations between insomnia and large vessel occlusion acute ischemic stroke: An observational study. Clinics (Sao Paulo) 2023; 78:100297. [PMID: 37924679 PMCID: PMC10660002 DOI: 10.1016/j.clinsp.2023.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/22/2023] [Accepted: 10/05/2023] [Indexed: 11/06/2023] Open
Abstract
OBJECTIVES This study explored the association between insomnia and the clinical outcome of large vessel occlusion Acute Ischemic Stroke (AIS) and attempted to explore its potential mechanisms from the perspectives of inflammation and oxidative stress. METHODS AIS patients who underwent endovascular treatment for large vessel occlusion at Binzhou Central Hospital from 2018 to 2022 (n = 508) were included. Patients were divided into an insomnia group and a non-insomnia group. Insomnia was judged by self-reported Athens Insomnia Scale score. Regression analysis was used to compare the differences in the 24-hour and 7-day National Institutes of Health Stroke Scale (NIHSS) score, Early Neurological Deterioration (END), early adverse event incidence, 90-day prognosis and mortality, and serum biomarkers levels. RESULTS The incidence of insomnia in the study population was 39.6% (n = 144, insomnia group; n = 364, non-insomnia group). Compared with the non-insomnia group, a worse prognosis outcome (63% vs. 49%, adjusted rate ratio: 1.8, 95% Confidence Interval: 1.2-3.7; p = 0.016), higher 24-h and 7-day NIHSS score (17 [9-36] vs. 13 [5-20]; p = 0.024, and 11 [4‒24) vs. 8 [2‒14]; p = 0.031, respectively), higher END (24% vs. 15%, p = 0.022), and higher incidence of adverse events were observed in the insomnia group (79% vs. 59%, p = 0.010). The 90-day mortality was higher in the insomnia group than that in the non-insomnia group (22% vs. 17%), however, such a difference was not statistically significant. CONCLUSION Insomnia is closely related to the clinical outcome of AIS with large vessel occlusion, and inflammation and oxidative stress mechanisms may be involved.
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Affiliation(s)
- Huali Xu
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; Department of Neurology, Binzhou Central Hospital, Binzhou Medical College, Binzhou, Shandong Province, China
| | - Weili Li
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiahao Chen
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Piao Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Siming Rong
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jinping Tian
- Department of Information, Binzhou Central Hospital, Binzhou Medical College, Binzhou, Shandong Province, China
| | - Yuqian Zhang
- Department of Neurology, Binzhou Central Hospital, Binzhou Medical College, Binzhou, Shandong Province, China
| | - Yanke Li
- Department of Neurology, Binzhou Central Hospital, Binzhou Medical College, Binzhou, Shandong Province, China
| | - Zhenzhen Cui
- Department of Neurology, Binzhou Central Hospital, Binzhou Medical College, Binzhou, Shandong Province, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China.
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Mekky J, Hafez N, Kholy OE, Elsalamawy D, Gaber D. Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study. BMC Neurol 2023; 23:387. [PMID: 37884861 PMCID: PMC10601304 DOI: 10.1186/s12883-023-03438-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Sleep difficulties following a cerebrovascular stroke are an interesting topic in the scientific community. Following a brain ischemic insult, a variety of sleep problems can occur. AIM OF WORK To study the sleep architecture following stroke and to identify the impact of site, size and severity of ischemic cerebrovascular troke on sleep microstructure. SUBJECTS AND METHODS this was a case control study; polysomnogram was done for 93 patients admitted to the stroke unit at El- Hadara university hospital with the first ever ischemic stroke. NIHSS was calculated immediately and 1 month after stroke onset. 50 age matched control subjects with no evidence of central nervous system or major psychiatric disorder by history or clinical examination. RESULTS Total sleep time, sleep efficiency were lower in ischemic cerebrovascular stroke patients than in control group and this was statistically significant (p = .001* p = .0001* respectively). Arousal index limb movement index and snoring index were all higher among the ischemic cerebrovascular stroke group in comparison to the control group and this was statistically significant (p = .0001*p = .05*p = .0001). Both the REM(rapid eye movement) and REM latency were highest among brain stem stroke, and this was statistically significant p = .043*, p = .0.001*.cortical infarcts showed higher AHI (apnea hypopnea index)and this was statistically significant p = 0.002* Limb movement index was higher among sizable size stroke and this was statistically significant (p = 0.038). NIHSS National Institutes of Health Stroke Scale after 1 month follow up showed a significant indirect correlation with the lowest oxygen saturation during sleep (p = 0.047). Lowest oxygen saturation was lowest among sizable stokes and desaturation index was highest among sizable size strokes both were statistically significant p = 0.006. NIHSS2 had a significant negative correlation with the lowest oxygen saturation during sleep p = 0.047. CONCLUSION The microstructure of sleep is significantly impacted by cerebrovascular stroke. Brain stem strokes had the highest REM and REM latency, while cortical strokes had the highest moderate-to-severe AHI. Sizable strokes displayed increased indices of limb movement, desaturation, and oxygen saturation.
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Affiliation(s)
- Jaidaa Mekky
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nadia Hafez
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Osama El Kholy
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa Elsalamawy
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Dina Gaber
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Wang D, Yan D, Yan M, Li R, Jiang H, Wang J, Yang H. Leukoaraiosis severity is related to increased risk of early neurological deterioration in acute ischemic stroke: a retrospective observational study. Acta Neurol Belg 2023:10.1007/s13760-023-02249-3. [PMID: 37014516 DOI: 10.1007/s13760-023-02249-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 03/22/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVES The relationship between leukoaraiosis and early neurological deterioration in acute cerebral infarction patients remains controversial. We tried to determine whether an association existed between leukoaraiosis and early neurological deterioration in patients with acute ischemic stroke. MATERIALS AND METHODS We retrospectively enrolled acute cerebral infarction patients admitted to our our department within 4.5-72.0 h of symptom onset between January 2016 and March 2022. On the basis of the van Swieten scale, leukoaraiosis was evaluated as supratentorial white matter hypoattenuation on admission head CT and graded as 0 (absent), 1 (mild), 2 (moderate) and 3-4 (severe). Early neurological deterioration was defined as an increase in the National Institute of Health Stroke Scale score by > = 2 points in the total score, or > = 1 point in motor power within the first seven days after admission. RESULTS Among 736 patients, 522 (70.9%) patients had leukoaraiosis, and of these, 332 (63.6%) had mild leukoaraiosis, 41 (7.9%) had moderate leukoaraiosis, and 149 (28.5%) had severe leukoaraiosis. 118 (16.0%) patients experienced early neurological deterioration: 20 of the 214 (9.5%) patients without leukoaraiosis and 98 of the 522 (18.8%) patients with leukoaraiosis. In multiple regression analysis, we found van Swieten scale predicted early neurological deterioration independently (OR = 1.570; 95% CI: 1.226-2.012). CONCLUSIONS Leukoaraiosis is common in acute cerebral infarction patients and leukoaraiosis severity is related to increased risk of early neurological deterioration in the patients.
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Affiliation(s)
- Dan Wang
- Department of Neurology, Hubei NO. 3 People's Hospital of Jianghan University, 26 Zhongshan Road, Qiaokou District, Wuhan, China
| | - Dan Yan
- Department of Neurology, Hubei NO. 3 People's Hospital of Jianghan University, 26 Zhongshan Road, Qiaokou District, Wuhan, China
| | - Mingmin Yan
- Department of Neurology, Hubei NO. 3 People's Hospital of Jianghan University, 26 Zhongshan Road, Qiaokou District, Wuhan, China
| | - Ruifang Li
- Department of Neurology, Hubei NO. 3 People's Hospital of Jianghan University, 26 Zhongshan Road, Qiaokou District, Wuhan, China
| | - Haiwei Jiang
- Department of Neurology, Hubei NO. 3 People's Hospital of Jianghan University, 26 Zhongshan Road, Qiaokou District, Wuhan, China
| | - Juan Wang
- Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Yang
- Department of Neurology, Hubei NO. 3 People's Hospital of Jianghan University, 26 Zhongshan Road, Qiaokou District, Wuhan, China.
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Toh ZA, Cheng LJ, Wu XV, De Silva DA, Oh HX, Ng SX, He HG, Pikkarainen M. Positive airway pressure therapy for post-stroke sleep disordered breathing: a systematic review, meta-analysis and meta-regression. Eur Respir Rev 2023; 32:32/167/220169. [PMID: 36889784 PMCID: PMC10032615 DOI: 10.1183/16000617.0169-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/24/2022] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) is an under-recognised independent risk factor and a potential consequence of stroke. We systematically reviewed and meta-analysed the effectiveness of positive airway pressure (PAP) therapy in improving post-stroke outcomes. METHODS We searched CENTRAL, Embase, PubMed, CINAHL, PsycINFO, Scopus, ProQuest, Web of Science and CNKI (China National Knowledge Infrastructure) for randomised controlled trials comparing PAP therapy against a control or placebo group. We evaluated the pooled effects of PAP therapy on recurrent vascular events, neurological deficit, cognition, functional independence, daytime sleepiness and depression using random effects meta-analyses. RESULTS We identified 24 studies. Our meta-analyses showed that PAP therapy reduced recurrent vascular events (risk ratio 0.47, 95% CI 0.28-0.78), and showed significant beneficial effects on neurological deficit (Hedges' g= -0.79, 95% CI -1.19- -0.39), cognition (g=0.85, 95% CI 0.04-1.65), functional independence (g=0.45, 95% CI 0.01-0.88) and daytime sleepiness (g= -0.96, 95% CI -1.56- -0.37). However, there was insignificant reduction in depression (g= -0.56, 95% CI -2.15-1.02). No publication bias was detected. CONCLUSIONS Post-stroke patients with SDB benefited from PAP therapy. Prospective trials are needed to determine the ideal initiation period and the minimum effective therapeutic dose.
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Affiliation(s)
- Zheng An Toh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Nursing, National University Hospital, Singapore
- National University Health System, Singapore
| | - Ling Jie Cheng
- National University Health System, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- National University Health System, Singapore
| | - Deidre Anne De Silva
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
| | - Hui Xian Oh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Nursing, National University Hospital, Singapore
- National University Health System, Singapore
| | - Si Xian Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Nursing, National University Hospital, Singapore
- National University Health System, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- National University Health System, Singapore
| | - Minna Pikkarainen
- Department of Occupational Therapy, Prosthetics and Orthoptics, Faculty of Health Sciences and Department of Product Design, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
- Martti Ahtisaari Institute, University of Oulu, Oulu, Finland
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Jin D, Yang J, Zhu H, Wu Y, Liu H, Wang Q, Zhang X, Dong Y, Luo B, Shan Y, Zhang L, Wang P, Du J. Risk factors for early neurologic deterioration in single small subcortical infarction without carrier artery stenosis: predictors at the early stage. BMC Neurol 2023; 23:83. [PMID: 36849878 PMCID: PMC9969648 DOI: 10.1186/s12883-023-03128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVES This study aimed to assess the epidemiological features and explore the potential risk factors for early neurological deterioration (END) in patients with acute single small subcortical infarction (SSSI) who underwent antiplatelet therapy without carotid artery stenosis. MATERIALS & METHODS Patients with SSSI, as confirmed by cranial magnetic resonance imaging (MRI), who were hospitalized within 48 h after the onset of symptoms were enrolled. END was mainly defined as increment in the National Institutes of Health Stroke Scale (NIHSS) score of ≥ 2 points or any new neurological deficit. Poor functional outcome was defined as modified Rankin Scale (mRS) score of > 2 points at 3-month after the onset. The association of END with multiple indicators was assessed at the early stage of admission using multivariate logistic regression analysis, and adjusted odds ratios (aORs) were calculated. RESULTS A total of 280 patients were enrolled from June 2020 to May 2021, of whom, END occurred in 44 (15.7%) patients (median age, 64 years; 70.5% male), while END occurred during sleep in 28 (63.6%) patients. History of hypertension (aOR: 4.82, p = 0.001), infarction in internal capsule (aOR: 3.35, p = 0.001), and elevated level of low-density lipoprotein cholesterol (LDL-C; aOR: 0.036, p = 0.0016) were significantly associated with the risk of END. Patients with END (aOR: 5.74, p = 0.002), history of diabetes (aOR: 2.61, p = 0.020), and higher NIHSS scores at discharge (per 1-score increase, aOR: 1.29, p = 0.026) were associated with the poor functional outcome at 3-month after the onset. CONCLUSION Patients with a history of hypertension, infarction in internal capsule or a higher level of LDL-C were found to be at a higher risk of END.
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Affiliation(s)
- Di Jin
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Jing Yang
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Hui Zhu
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Yuexia Wu
- grid.256883.20000 0004 1760 8442Graduate School of the First Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Haichao Liu
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Qi Wang
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Xiaoyun Zhang
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Yanhua Dong
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Bin Luo
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Yong Shan
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Lvming Zhang
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Peifu Wang
- grid.464204.00000 0004 1757 5847Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049 People’s Republic of China
| | - Jichen Du
- Department of Neurology, Aerospace Center Hospital, Yuquan Road 15, Haidian District, Beijing, 100049, People's Republic of China.
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Zhang Y, Xia X, Zhang T, Zhang C, Liu R, Yang Y, Liu S, Li X, Yue W. Relationship between sleep disorders and the prognosis of neurological function after stroke. Front Neurol 2022; 13:1036980. [DOI: 10.3389/fneur.2022.1036980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis study aims to investigate the effects of sleep disorders on the prognosis of neurological function after stroke and other factors affecting the prognosis after stroke.MethodWe designed a cohort study. A total of 1,542 patients with their first stroke were hospitalized in the department of neurology of Tianjin Huanhu Hospital from 2015.6.1 to 2016.12.31. We recorded the personal histories of patients. The MMSE (mini-mental state examination), MoCA (Montreal Cognitive Assessment), HAMD (Hamilton Depression Scale), National Institutes of Health Stroke Scale (NIHSS) score, mRS (Modified Rankin Scale), BI (Barthel Index), PSQI (Pittsburgh Sleep Quality Index), ESS (Epworth Sleepiness Scale), Berlin questionnaire, and nocturnal TST (Total sleep time) were assessed before discharge, 3 months, 6 months, and 4 years (2019–2020) after stroke.ResultLow sleep quality (OR 2.019, 95%CI 1.199–3.398, p = 0.008), nocturnal TST (<7 h) (OR 4.060, 95%CI 1.494–11.034, p = 0.006), nocturnal TST (>8 h) (OR 5.928, 95% CI 2.134–16.464, p = 0.001) were risk factors for poor neurological function recovery at 3 months after stroke. Nocturnal TST (<7 h) (OR 13.042, 95%-CI 2.576–66.027, p = 0.002) and nocturnal TST (>8 h) (OR 11.559, 95%-CI 2.108–63.390, p = 0.005) were risk factors for poor neurological function at 6 months after stroke. Nocturnal TST (<7 h) (OR 2.668, 95% CI 1.250–5.698, p = 0.011) and nocturnal TST (>8 h) (OR 2.516, 95% CI 1.080–5.861, p = 0.033) were risk factors for poor neurological function at 4 years after stroke. High risk of OSA (HR 1.582, 95%CI 1.244–2.012, p < 0.001) was a risk factor for all-cause death in patients followed up for 4 years after stroke.ConclusionLow sleep quality is associated with short-term poor neurological function after stroke. Unusual nocturnal TST (long or short) is associated with short-term or long-term poor neurological function after stroke. A high risk of OSA is associated with a higher risk of all-cause death after stroke.
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Validation Study of the Richards-Campbell Sleep Questionnaire in Patients with Acute Stroke. J Pers Med 2022; 12:jpm12091473. [PMID: 36143258 PMCID: PMC9505129 DOI: 10.3390/jpm12091473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
Sleep disorders are frequent in acute stroke. The Richards-Campbell Sleep Questionnaire (RCSQ) is a validated scale for the sleep assessment in intensive care unit. The aim of the present study is to validate RCSQ for use in patients with acute stroke. We performed a validation study by comparing the RCSQ with polysomnography (PSG), the standardized measure of sleep. Inclusion criteria were age ≥ 18 years and a radiologically confirmed diagnosis of stroke. Exclusion criteria were global aphasia, extreme severity of clinical conditions and inability to attend PSG. All patients underwent PSG in a stroke unit, the day after a subjective sleep assessment by means of the RCSQ. The RCSQ was compared with PSG parameters to assess the degree of concordance of the two measures. The cohort consisted of 36 patients. Mean RCSQ score was 61.5 ± 24.8. The total score of the RCSQ showed a good degree of concordance with the sleep efficiency index of PSG. Accuracy of the RCSQ was 70%, sensitivity 71% and specificity 68%. The RCSQ is a good tool for screening the sleep quality in the setting of a stroke unit. Therefore, it could be useful to select the patients who might beneficiate from an instrumental sleep evaluation.
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Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship. Curr Neurol Neurosci Rep 2022; 22:767-779. [PMID: 36190654 PMCID: PMC9633474 DOI: 10.1007/s11910-022-01234-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW To elucidate the interconnection between sleep and stroke. RECENT FINDINGS Growing data support a bidirectional relationship between stroke and sleep. In particular, there is strong evidence that sleep-disordered breathing plays a pivotal role as risk factor and concur to worsening functional outcome. Conversely, for others sleep disorders (e.g., insomnia, restless legs syndrome, periodic limb movements of sleep, REM sleep behavior disorder), the evidence is weak. Moreover, sleep disturbances are highly prevalent also in chronic stroke and concur to worsening quality of life of patients. Promising novel technologies will probably allow, in a near future, to guarantee a screening of commonest sleep disturbances in a larger proportion of patients with stroke. Sleep assessment and management should enter in the routinary evaluation of stroke patients, of both acute and chronic phase. Future research should focus on the efficacy of specific sleep intervention as a therapeutic option for stroke patients.
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Gong L, Ruan C, Yang X, Lin W. Effects of Predictive Nursing Intervention among Patients with Acute Stroke. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1398-1404. [PMID: 34568178 PMCID: PMC8426776 DOI: 10.18502/ijph.v50i7.6629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/08/2020] [Indexed: 11/24/2022]
Abstract
Background: To explore the effects of predictive nursing intervention among patients with acute stroke. Methods: One hundred and sixty participants were included. They were hospitalized in the Department of Neurology of a third-level first-class hospital in Changsha, Hunan Province, from January to August 2019. They were categorized into control group and intervention group by random number table, with 80 patients in each group. General nursing for patients in Neurology Department was offered to the control group. On the basis of general nursing, predictive nursing intervention was offered to the intervention group. The effectiveness of predictive nursing intervention were evaluated by disparity in neurologic function, movement function, daily life ability and sleep quality before intervention and 2 weeks after intervention. The neurologic function, movement function, daily life ability and sleep quality were evaluated by National Institute of Health acute stroke scale (NIHSS), Fugl-Meyer scale, Barthel indicator, and Pittsburgh sleep quality indicator (PSQI), respectively. Results: There was no significant difference in gender, age, complications and treatment methods between two groups. There was no significant difference in the scores of NIHSS, Fugl-Meyer scale, Barthel indicator, and PSQI before intervention. The scores of NIHSS and PSQI were significantly lower in the intervention group than those in the control group, and the scores of Fugl-Meyer scale and Barthel indicator were significantly higher in the intervention group than those in the control group (P <0.05). Conclusion: Predictive nursing intervention could help improve not only neurologic function, movement function, and daily life ability, but also sleep quality among patients with acute stroke.
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Affiliation(s)
- Lina Gong
- Department of Neurology, The Third Xiangya Hospital of Central South University, Changsha 410013, China.,Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Chunhong Ruan
- Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha 410013, China.,Department of Hematology, The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Xuan Yang
- Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Wanli Lin
- Department of Neurology, The Third Xiangya Hospital of Central South University, Changsha 410013, China
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Xie X, Xiao J, Wang Y, Pan L, Ma J, Deng L, Yang J, Ren L. Predictive Model of Early Neurological Deterioration in Patients with Acute Ischemic Stroke: A Retrospective Cohort Study. J Stroke Cerebrovasc Dis 2021; 30:105459. [PMID: 33387889 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105459] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study aimed to develop a predictive model of early neurological deterioration (END) in patients with acute ischemic stroke (AIS). METHODS The present retrospective cohort study considered patients with AIS who were admitted to a tertiary hospital in Shenzhen, China between January 2014 and December 2018. An increase of 2 points or more on the National Institute of Health Stroke Scale (NIHSS) within 7 days indicated END. We selected baseline clinical, laboratory, and neuroimaging variables to construct predictive models through multivariate logistic regression. The receiver operating characteristic curve and calibration plots were calculated. RESULTS A total of 391 patients with AIS were enrolled in the study. END was observed in 64 (16.4%) cases. A prediction model developed from the initial NIHSS score, middle cerebral artery stenosis, and carotid stenosis of≥ 50% showed good discriminative ability: area under the receiver operating characteristic curve, 0.870 (95%CI, 0.813-0.911); threshold, -1.570; specificity, 84.40%; sensitivity, 75.00%; positive predictive value, 48.48%; and a negative predictive value, 94.52%. CONCLUSION Our predictive model developed from the initial NIHSS score, middle cerebral artery stenosis, and carotid stenosis of ≥ 50% could identify patients with AIS who were at risk of developing END. The model requires validation by larger studies performed at other institutions.
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Affiliation(s)
- Xiaohua Xie
- Department of Nursing, The First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 518035 Shenzhen, China.
| | - Jingyi Xiao
- School of Nursing, Guangzhou Medical University, Guangzhou 510030, China.
| | - Yunyun Wang
- Department of Nursing, Children's Hospital of Anhui Medical University, Heifei, 230000, China.
| | - Lu Pan
- Department of Nursing, The First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 518035 Shenzhen, China.
| | - Jiahui Ma
- Clinical College of The Second Shenzhen Hospital, Anhui Medical University, Shenzhen, 518035, China.
| | - Liping Deng
- Department of Nursing, The First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 518035 Shenzhen, China.
| | - Jie Yang
- Clinical College of The Second Shenzhen Hospital, Anhui Medical University, Shenzhen, 518035, China.
| | - Lijie Ren
- Department of Neurology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University, 3002 Sungang West Road, Futian District, Shenzhen, Guangdong 518035, China.
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