| Objective(s):To explore the incidence and influencing factors of sleep disorders in patients with ischemic stroke,along with the value and relationship of sex hormones in evaluating sleep disorders in patients with ischemic stroke.Methods:The patients with ischemic stroke who were hospitalized in the Department of Neurology in the Second Affiliated Hospital of Kunming Medical University from August 2019 to January 2020 were included in the study.According to the Pittsburgh Sleep Quality Index Scale(PSQI)patients with greater than or equal to 7 points,were divided into a sleep disorder group(PSQI>7 points)and a non-sleep disorder group(PSQI<7 points).The relevant clinical data were collected,comparison of sex hormone levels(estrogen,progesterone,testosterone,etc.),sleep parameters,mental status,stroke location,and neurological deficit was conducted among both genders,and analyzed.The relationship between sex hormone levels and sleep parameters and sleep scale scores was also analyzed.Results:1.A total of 125 patients with ischemic stroke were included.There were 55 cases(44%)in the sleep disorder group and 70 cases(56%)in the non-sleep disorder group.The prevalence of ischemic stroke sleep disorder was 44%.2.The general data comparison between the two groups of patients showed that the gender difference between the sleep disorder group and the non-sleep disorder group was statistically significant(P<0.05).The incidence of sleep disorders in female stroke patients was 57.7%,and the incidence of sleep disorders in male stroke patients was 34.2%.The incidence of sleep disorders in women was significantly higher than that of in men.Gender may be an influencing factor for sleep disorders.3.Compare to with the non-sleep disorder group,there was a statistically significant difference in the prevalence of sleep disorders between the stroke site and thalamus(P<0.05).The incidence of sleep disorders during infarction at different sites:thalamus infarction was the highest(68.8%),followed by brain stem(50%),basal ganglia area(47.7%),frontal lobe(45.3%)and cerebellum(18.2%).4.Compare to the non-sleep disorder group,the NIHSS score,anxiety and depression scores of the two groups were statistically significant.The NIHSS score,anxiety and depression score of the sleep disorder group were higher than those of the non-sleep disorder group,NIHSS score and PSQI had a significant positive correlation.The higher the NIHSS score,the higher the incidence of sleep disorders and the worse the sleep quality of patients.5.Compared with the sex hormones in the sleep disorder group and the non-sleep disorder group,there was no statistically significant difference in sex hormone indexes between the two groups(P>0.05),but after gender analysis,(1)female patients with sleep disorder group and non-sleep disorder group,the difference in estradiol was statistically significant(P<0.05).The level of estradiol in women with sleep disorders was significantly lower than that in women with non-sleep disorders.(2)The difference of testosterone between male sleep disorder group and non-sleep disorder group was statistically significant(P<0.05),the testosterone level of male in sleep disorder group was significantly lower than that of male in non-sleep disorder group.6.Testosterone in male patients significantly correlated to sleep time(r=0.24,P<0.05)and sleep efficiency(r=0.44).The lower the testosterone level,the worse the sleep efficiency.In male patients,the Pittsburgh Sleep Quality Index scale score was significantly negatively correlated with testosterone(P<0.05).The lower the testosterone level,the worse the sleep quality and the higher the PSQI score.Female patients' estradiol is related to sleep time(r=0.33)and wake-up time(r=-0.38).The lower the estradiol,the longer the wake-up time.The Pittsburgh Sleep Quality Index Scale score was negatively correlated with estradiol in female patients(P<0.05).The lower the estradiol level,the worse the sleep quality and the higher the PSQI score.Conclusion:1.The incidence of sleep disturbance in patients with ischemic stroke is relatively high,which may be related to the gender,stroke location,mental state,and neurological deficits.2.Among the patients with ischemic stroke sleep disorders may have changes in sleep structure and sleep progress,manifested by shortened sleep time,prolonged sleep latency and wake up time,increased wake up times,and reduced sleep efficiency.3.In female patients with ischemic stroke and sleep disturbance,estradiol level is the influencing factor of sleep disturbance in patients with ischemic stroke.The lower the estradiol level,the shorter the sleep time and the longer the awakening time of the patient.The testosterone level in male patients is the influencing factor of sleep disturbance in patients with ischemic stroke.The lower testosterone level is associated with the short sleep time and lower sleep efficiency of the patient,thus increasing the prevalence of sleep disorder. |
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