Correlation Between Sleep Quality And Executive Function In Patients With Acute Ischemic Stroke

Background Acute ischemic stroke(AIS)refers to ischemic hypoxic degeneration and necrosis of brain tissue caused by blood flow disorders of local supplying arteries of brain tissue from various causes and related clinical neurological loss.Studies have found that patients with AIS not only have functional disorders,but also sleep disorders and cognitive disorders to a certain extent,which seriously affect the prognosis of patients.Basic studies have confirmed that extensive changes in intracranial vascular circulation occur after AIS,which may be an important cause of post-stroke sleep disorders.In recent years,there have been many studies on sleep disorders during the convalescent period of stroke,while few studies on the sleep quality of AIS patients.In addition,it is not clear whether the sleep quality of AIS patients has a negative impact on the occurrence of sleep disorders and cognitive impairment during the recovery period.This study intends to use neuropsychological evaluation methods to explore the characteristics of sleep quality in AIS patients,potential risk factors affecting sleep quality and possible neural mechanisms.and to explore the correlation between sleep quality and executive function in AIS patients.In order to provide reference for clinical intervention,delay or even prevent the occurrence of cognitive impairment after stroke.Objective The sleep quality and executive function of patients with AIS were evaluated comprehensively,and the status and characteristics,potential risk factors and possible neural mechanisms of sleep quality in patients with AIS were explored.(1)To investigate the occurrence status of sleep quality in AIS patients and explore the characteristics and influencing factors of sleep disorders in AIS patients.(2)To explore the relationship between sleep disorders and cognitive function scores in AIS patients.(3)To explore the current status of executive function in AIS patients,and further explore the relationship between sleep quality and executive function.Methods(1)Study 1:Patients’ general clinical data Questionnaire,Pittsburgh sleep quality index(PSQI)and Changsha version of the Montreal cognitive assessment(Mo CA)to assess sleep quality and cognitive function in AIS patients,Firstly,the current characteristics of sleep quality of AIS patients and potential risk factors affecting sleep quality of AIS patients were analyzed,And further explore the effects of AIS sleep disorders on cognitive function.(2)Study 2:The Color trail test(CTT)was used to evaluate the executive function of AIS patients,To explore the characteristics of executive function in AIS patients,further analyze the correlation between AIS sleep quality and executive function,and further explore the influence of sleep quality on executive function in the acute stage of ischemic stroke.Results(1)Study 1:The PSQI score of 192 patients with AIS was(7.20±4.21).The subdimensions were sleep quality(1.10±0.65)points,sleep time(1.50±1.01)points,sleep time(1.28±1.12)points,sleep efficiency(1.29±1.17)points,sleep disorders(1.24±0.59)points,hypnotic drugs(0.20±0.69)points and daytime dysfunction(0.69± 0.90)points.In this study,the incidence of sleep disorders in AIS patients was42.71%.Univariate analysis showed that gender and drinking history were influencing factors of sleep disorders in patients with AIS(P<0.05).Multivariate analysis showed that female and age were influencing factors of AIS sleep disorders.The difference was statistically significant(P<0.05).In Mo CA cognitive function analysis of all dimensions,the score of orientation distribution was lower in the sleep disorder group than in the non-sleep disorder group,and the difference was statistically significant,The visual spatial/executive distribution scores were lower in the sleep disorder group than in the non-sleep disorder group(Z=-2.661,P=0.008).(2)Study 2:In 192 patients with AIS,CTTI was 80.64(57.78,115.24)s,CTT-II was 171.08(129.02,222.23)s,and the wiring interference effect was 85.71(61.29,112.87)s.AIS sleep disorder group and non-sleep disorder group showed statistically significant differences in the overall distribution of CTT-I,CTT-II and wired interference effects(P<0.05).Correlation analysis showed that the total score of PSQI was positively correlated with CTT-I(r=0.157,P<0.05)and CTT-II(r=0.184,P<0.05).The total score of PSQI was not correlated with the wiring interference effect.Correlation analysis of each dimension showed that sleep time was positively correlated with CTT-I(r =0.165,P < 0.05),CTT-II(r =0.203,P < 0.01)and the wire interference effect(r=0.165,P < 0.05).Sleep efficiency was positively correlated with CTT-I(r=0.200,P < 0.01),CTT-II(r=0.223,P < 0.01)and wired interference effect(r=0.171,P<0.05).Hypnotic drugs were positively correlated with CTT-I(r=0.163,P<0.05)and CTT-II(r=0.165,P<0.05).Daytime dysfunction was positively correlated with CTT-I(r=0.265,P<0.01)and CTT-II(r=0.215,P<0.01).Conclutions(1)AIS patients have poor sleep quality,and the sleep disorder rate of AIS patients is high.(2)Age and gender are risk factors for sleep disorders in AIS patients.The older the patient is,the worse the sleep quality will be.Compared with men,women have a higher risk of sleep disorders.(3)AIS patients with sleep disorders had poorer orientedness and visuospatial/executive function compared with the non-sleep disorder group.(4)AIS patients had poor executive function,and overall executive function was worse in the AIS with sleep disorder group compared with the non-sleep disorder group.(5)Sleep quality in AIS patients is related to executive function,suggesting that sleep quality may provide a certain reference basis for poor executive function in AIS patients.