【10 月29日世界中風日】
世界上有很多研究有關中風和睡眠障礙的關係。 有證據顯示,中風後有很大機會患有睡眠障礙[1],而睡眠障礙也會提高患有中風的機率[2]。 未經治療的睡眠障礙甚至會阻礙中風後的康復,並增加中風復發的風險[3]。
睡眠窒息症是中風後診斷出的最常見的睡眠障礙之一。它是一種睡眠呼吸障礙,特點是在睡眠期間反復閉上呼吸道。 睡眠窒息症與多種血管疾病密切相關,包括高血壓、心房顫動,而所種血管疾病是中風的主要原因[4]。 因此,許多睡眠障礙與中風密切相關,72% 的中風患者被診斷出患有睡眠呼吸障礙[5]。
睡眠對肌肉運動學習有重要影響,運動學習是中風後康復的核心機制[6]。 研究表明中風患者在睡眠後第二天,新學習的運動任務中表現更好[7]。 研究還顯示,睡眠障礙對中風恢復的所有階段都有負面影響,包括更長的住院時間[8]。
引文
[i] Laver, Kate E et al. “Sleep Disturbance and Disorders within Adult Inpatient Rehabilitation Settings: A Systematic Review to Identify Both the Prevalence of Disorders and the Efficacy of Existing Interventions.” Journal of the American Medical Directors Association vol. 21,12 (2020): 1824-1832 [ii] Yaggi, H. Klar et al. “Obstructive Sleep Apnea as a Risk Factor for Stroke and Death.” The New England journal of medicine 353.19 (2005): 2034–2041. [iii] Birkbak J, Clark AJ, Rod NH. The effect of sleep disordered breathing on the outcome of stroke and transient ischemic attack: a systematic review. J Clin Sleep Med. 2014;10: 103-108. [iv] Sanchez-De-la-Torre, Manuel, Francisco Campos-Rodriguez, and Ferran Barbe. “Obstructive Sleep Apnoea and Cardiovascular Disease.” The lancet respiratory medicine 1.1 (2013): 61–72 [v] Johnson, Karin G, and Douglas C Johnson. “Frequency of Sleep Apnea in Stroke and TIA Patients: a Meta-Analysis.” Journal of clinical sleep medicine 6.2 (2010): 131–137. [vi] Fulk, George D. et al. “The Impact of Sleep Disorders on Functional Recovery and Participation Following Stroke: A Systematic Review and Meta-Analysis.” Neurorehabilitation and neural repair 34.11 (2020): 1050–1061. [vii] Siengsukon, Catherine et al. “Sleep Parameters, Functional Status, and Time Post-Stroke Are Associated with Offline Motor Skill Learning in People with Chronic Stroke.” Frontiers in neurology 6 (2015): 225–225. [viii] KANEKO, Yasuyuki et al. “Relationship of Sleep Apnea to Functional Capacity and Length of Hospitalization Following Stroke.” Sleep (New York, N.Y.) 26.3 (2003): 293–297.