Sleep Architecture In Acute Stroke And Correlation Factor

ObjectiveThe aim of this study was to investigate sleep architecture in acute stroke patients.Methods86 patients were included in the study from September,2008 to December,2010. Inclusion criteria were confirmed by MRI and in two weeks. The whole night sleep records of 86 patients with acute stroke were monitored by 32-head video-taped polysomnographic system, and the results were compared with the data of 63 normal subjects. Sleep architecture was analyzed according to SDB, the topography of lesion and severity(National Institutes of Health Stroke Scale) of stroke.Results①Compared to the control group, the acute stroke patients have reductions in total sleep time, sleep efficiency and REM sleep (P<0.01), increased wakefulness during sleep (P<0.01):The total sleep times are 336.9±99.2min and 414.7±123.7min; The sleep efficiencies are 60.7±18.7% and 72.7±16.9%; REM sleeps are 11.1±9.0% and 17.1±7.9%; The wakefulnesses are 24.1±14.4% and 14.9±11.9%.②Acute stroke patients with SDB have 65.1%. Compared to the control group, the acute stroke patients have reductions in total sleep time, sleep efficiency (P< 0.01), increased wakefulness during sleep (P<0.01). But stroke patients with SDB have increased stage I and reduced REM sleep (P<0.05). compared with mild stroke patients, severe stroke patients have increased total sleep time, stage I and REM latency (P<0.05):The total sleep times are 381.8±86 min and 301.8±124.2 min. Sleep stages I are 48.3±24.8% and 35.2±16.6%. REM latencies are 178.4±168.7% and 118.5±114.1%.③Compared to other topographies, sleep architecture is disrupted in cortical strokes (P<0.05). It represents that stroke patients have reductions in total sleep time, sleep efficiency, slow wave sleep, REM sleep and REM latency, increased stage I, wakefulness and sleep latency. Although the multiple strokes sleep architectures are disturbed, however the ratios of NREM sleep to REM sleeps are not influenced.④REM sleep is negatively associated with stroke severity (r2=0.537, P=0.00).ConclusionStroke patients have reductions in sleep efficiency and disturbances in sleep architecture, and this correlates with the topography, severity and the presence of sleep apnea syndrome. So sleep functions with acute stroke patients should be examined and evaluated. More attention should be focused on identifying and treating sleep disorders, in order to change unhealthy prognosis of stroke patients.