Clinical Research In Excessive Daytime Sleepiness After Acute Cerebral Infarction

Objective:To investigate the clinical features and influential factors of excessivedaytime sleepiness in patients with acute cerebral infarction, and to find theoreticalbasis and measure for clinical diagnosis and intervention.Methods:We studied consecutive patients with first-ever ischemic stroke in thedepartment of Neurology，in the Second affiliated Hospital of Nanchang Universityfrom July,2011to July,2012. The selected patients were examined by EpworthSleepiness Scale (ESS)．Then the patients were divided into non daytime sleepinessgroup（ESS<6）、daytime sleepiness group（6≤ESS<10）、 excessive daytimesleepiness group （ESS≥10）， all patients were examined by related scalequestionnaire and polysomnography (PSG),then comparatively analyzed the clinicaldata among the three groups, including average age,gender, anamnesis, smokinghistory, Body Mass Index, cognitive function, the position of cerebral infarction,nerve function damage, daytime activities, Apnea-hypopnea Index and so on.Research clinical feature and influential factors on excessive daytime sleepiness inacute ischemic stroke patients.Result:Ninety-two patients with acute cerebral infarction,thirty-four patients(36.96%) experienced excessive daytime sleepiness,eighteen patients（19.57%）experienced slight excessive daytime sleepiness (6≤ESS<10),sixteen patients（17.39%）experienced severe excessive daytime sleepiness(ESS≥10). Comparingcommon data among the three groups, including average age,gender, anamnesis,smoking history, Body Mass Index and Apnea-hypopnea Index,it showed no statisticdifferences（P>0.05）.Acute thalamic infarction patients were likely to have moresleep time,secondly multiple site infarction and subcortical infarctionpatients.68.48%patients(63/92) experienced sleep-disordered breathing,93.75%patients were in severe excessive daytime sleepiness group(ESS≥10),66.11%patients were in slight excessive daytime sleepiness group(6≤ESS<10),63.79% patients were in no excessive daytime sleepiness group(ESS<6)（P<0.05）.The moreexcessive daytime sleepiness,the more damage on nerve function,daytime activitiesand cognitive function（P<0.05）.Conclusion: Patients with acute ischemic stroke show higher incidence of daytimesleepiness,it is not related to common data,but correlates with thalamic infarction,nerve function damage, daytime activities disorder and cognitive function.Sleep-disordered breathing may be the risk factor for excessive daytime sleepiness.Early screening,diagnosis and intervention may be better for prognosis of acuteischemic stroke in clinical practice．...