急性后循环缺血性脑卒中患者睡眠状态变化与预后影响因素的研究

Background&nbsp;Patients with stroke often experience sleep disturbances and imbalanceswhich are easily overlooked in clinical treatment. Moreoverthere is currently limited research on whether sleep status affects the prognosis of such diseases. Objective&nbsp;Exploration of factors influencing Sleep state changes and prognosis in patients with acute posterior circulation ischemic stroke. Methods&nbsp;A total of 60 patients with acute posterior circulation ischemic strokeadmitted to Kailuan General Hospitalaffiliated with North China University of Science and Technologyfrom December 2019 to December 2023 were selected as the case group. Based on the modified Rankin ScalemRSscore at dischargethe case group was divided into a good prognosis subgroup45 casesand a poor prognosis subgroup15 cases. Additionally52 patients without cerebral vascular stenosis and acute ischemic stroke during the same period were selected as the control group. General and clinical data of the patients were collected to compare the circadian sleep-wake rhythmsdaytime sleep-wake rhythmsnighttime sleep-wake rhythmsand the distribution of infarcted brain regions between the good prognosis subgroup and the poor prognosis subgroup. Multivariate logistic regression analysis was used to identify the prognostic factors influencing the outcomes of patients with acute posterior circulation ischemic stroke. Results&nbsp;The apnea-hypopnea indexAHIin the case group was higher than in the control groupP<0.05. The proportions of patients in the case group with reversed sleep cyclesincreased daytime sleepand difficulty falling asleep were higher than those in the control groupwith statistically significant differencesP<0.05. The case group showed higher total daytime sleep timewake time after sleep onsetlight sleep durationdeep sleep durationNREM sleep durationREM sleep durationREM sleep proportionand deep sleep proportion compared to the control groupwhereas the proportions of NREM sleep and light sleep were lowerall with statistically significant differencesP<0.05. The case group also exhibited longer total nighttime sleep timelight sleep durationand NREM sleep duration than the control group with statistically significant differencesP<0.05. The proportion of pontine infarction in the poor prognosis subgroup was higher than in the good prognosis subgroupwith a statistically significant differenceP<0.05. Multivariate logistic regression analysis showed that daytime deep sleep durationOR=1.20395%CI=1.032-1.401and pontine infarctionOR=16.497 95%CI=1.142-238.391were influencing factors for the prognosis of acute posterior circulation ischemic strokeP<0.05. Conclusion&nbsp;Patients with acute posterior circulation ischemic stroke exhibit an increased apnea-hypopnea indexAHIand present with sleep characteristics such as reversed sleep cyclesincreased daytime sleepand difficulty falling asleep at night. Additionallydaytime deep sleep duration and pontine infarction are factors that adversely affect the prognosis of these patients.