Correlation Between Dysphagia And Sleep Disordered Breathing In Patients With Acute Ischemic Stroke

Objective: By exploring the relevance between dysphagia and sleep-disordered breathing in patients with acute ischemic stroke,so as to provide reference for the diagnosis and treatment of patients with sleep-disordered breathing after stroke.Methods: A total of 60 patients with acute ischemic stroke were selected based on the inclusion criteria in the Department of Neurology of our hospital from August 2021 to February 2022.According to the modified Mann Swallowing Ability Assessment Scale and Kubota Water Swallowing Test,the patients were divided into observation group with 28 cases with dysphagia,and control group with 32 cases without dysphagia.All patients were monitored by polysomnography(PSG)in a monitoring room with sound insulation and appropriate temperature,which was suitable to sleep.Besides,the relevant indicators(AHI,OAI,CAI,HI,ODI and LSa O2)in PSG for evaluation of sleep-disordered breathing were observed.By utilizing the independent sample T test,non-parametric test and Chi-square test,Univariate logistic regression,multivariate logistic regression and Spearman correlation analysis to explore the relationship and correlation between dysphagia and sleep-disordered breathing after stroke.Results:(1)There was no significant difference between the two groups(P>0.05)in the Various clinical data(age,height,weight,BMI,and neck circumference,NIHSS,MRS,MOCA,HAMD,and PSQI scores,total sleep time,gender,history of snoring,history of smoking,history of alcohol consumption,history of hypertension,history of diabetes,coronary heart disease,history of dyslipidemia and lesion site).(2)Multiple logistic regression analysis showed that dysphagia(OR=23.163,95%CI:5.047-106.303)and age(OR=1.084,95%CI:1.002-1.172)were associated with an increased risk of sleep-disordered breathing.(3)The results of non-parametric test showed that the MASA score of patients without sleep-disordered breathing was higher than that of patients with sleep-disordered breathing(P<0.05),and the grade of Kubota Water Swallowing Test of patients with sleep-disordered breathing was higher than that of patients without sleep-disordered breathing(P<0.05).(4)The non-parametric test results showed that there was no significant difference in CAI between the two groups(P>0.05).The median levels of AHI,OAI,HI and ODI in the dysphagia group were higher than those in the non-dysphagia group(all P<0.05),while the median LSa O2 of the dysphagia group was lower than that of the no dysphagia group(P<0.05).(5)Spearman correlation analysis showed that MASA score was negatively correlated with AHI(R=-0.666,P<0.001),OAI(R=-0.671,P<0.001),HI(R=-0.449,P<0.001),and ODI(R=-0.618,P<0.001),but positively correlated with LSa O2(R=0.699,P<0.001).The grading of Kubota Water Swallowing Test was positively correlated with AHI(R=0.746,P<0.001),OAI(R=0.694,P<0.001),CAI(R=0.261,P<0.044),HI(R=0.538,P<0.001)and ODI(R=0.694,P<0.001),but negatively correlated with LSa O2(R=-0.722,P<0.001).Conclusion:(1)The risk of sleep-disordered breathing in patients with acute ischemic stroke complicated with dysphagia was increased,in which OSAHS was the predominant factor.(2)The severity of dysphagia in patients with acute ischemic stroke was positively correlated with the severity of sleep-disordered breathing.