首次急性缺血性卒中患者发病前睡眠障碍的调查

目的 探讨首次急性缺血性卒中患者发病前的睡眠状况.方法 纳入2015年7月至2016年7月在宣武医院神经内科住院的253例首次急性缺血性卒中患者,应用匹兹堡睡眠质量指数量表、Epworth思睡量表、STOP-BANG问卷、不安腿综合征筛查问卷、RBDSQ中文版量表针对患者住院以前有无失眠症状、睡眠呼吸暂停综合征高风险性,有无不安腿综合征,有无快速眼动睡眠期行为障碍(RBD)睡眠情况对患者本人及其家属进行问卷调查.结果 男性患者151例,年龄(68.4±9.4)岁;女性102例,年龄(69.7±9.5)岁.全部患者的匹兹堡睡眠质量指数量表(PSQI)评分为9.0±3.9,STOP-BANG评分为3.9±1.8,两者均高于正常范围.男性患者的STOP-BANG评分以及RBDSQ评分显著高于女性患者.全部患者中,有失眠症状(PSQI≥8分)的患者比例为47.4％(120/253),有日间思睡症状(ESS＞10分)的患者比例为24.5％(62/253),有睡眠呼吸暂停综合征高风险(STOP-BANG问卷＞3分)的患者比例为48.6％(123/253),临床诊断不安腿综合征比例为4.0％ (10/253),有RBD现象(RBDSQ中文版＞5分)的患者比例为7.1％ (18/253).其中男性患者的睡眠呼吸暂停综合征高风险的比例以及有RBD现象的比例显著高于女性患者.结论 首次急性缺血性卒中患者发病前伴有多种睡眠障碍,睡眠呼吸障碍、失眠以及不安腿综合征可能与卒中的发生有一定的相关性.

Investigation on sleep disorders in patients with first acute ischemic stroke

Objective To investigate the sleep status of the patients before the first acute ischemic stroke attack.Methods The study included 253 patients with first acute ischemic stroke from July,2015 to July,2016.All the patients and their families were investigated on whether or not they had sleep problems like insomnia,high risk of sleep apnea syndrome,restless legs syndrome and RBD using the Pittsburgh sleep quality index scale,Epworth sleepiness scale,STOPBANG questionnaire,restless legs syndrome screening questionnaire and RBDSQ Chinese version scale.Results A total of 151 of the patients were male and the age was (68.4±9.4) years old,102 were female and the age was (69.7±9.5) years old.The PSQI score of all patients was 9.0±3.9 and the STOP-BANG score was 3.9±1.8,both of which were higher than the normal range.STOP-BANG score and RBDSQ score were significantly higher in male patients than in female patients.In all patients,47.4％ (120/253) had symptoms of insomnia(PSQI ≥ 8),24.5％ (62/253) had daytime sleepiness symptoms (ESS＞10),48.6％ (123/253) had high risk of sleep apnea syndrome (STOP-BANG questionnaire ＞3),4.0％ (10/253) had clinical diagnosed restless legs syndrome,7.1％ (18/253) had phenomenon of RBD (RBDSQ Chinese version scale ＞5).The proportion of male patients with high risk of sleep apnea syndrome and the proportion of RBD were significantly higher than those of female patients.Conclusion Patients have a variety of sleep disorders before the first acute ischemic stroke attack.Sleep disordered breathing,insomnia and restless legs syndrome may be associated with the occurrence of stroke.