Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study

Abstract Background Sleep difficulties following a cerebrovascular stroke are an interesting topic in the scientific community. Following a brain ischemic insult, a variety of sleep problems can occur. Aim of work To study the sleep architecture following stroke and to identify the impact of site, s...

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Main Authors: Jaidaa Mekky, Nadia Hafez, Osama El Kholy, Doaa Elsalamawy, Dina Gaber
Format: Article
Language:English
Published: BMC 2023-10-01
Series:BMC Neurology
Subjects:
Online Access:https://doi.org/10.1186/s12883-023-03438-6
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author Jaidaa Mekky
Nadia Hafez
Osama El Kholy
Doaa Elsalamawy
Dina Gaber
author_facet Jaidaa Mekky
Nadia Hafez
Osama El Kholy
Doaa Elsalamawy
Dina Gaber
author_sort Jaidaa Mekky
collection DOAJ
description Abstract Background Sleep difficulties following a cerebrovascular stroke are an interesting topic in the scientific community. Following a brain ischemic insult, a variety of sleep problems can occur. Aim of work To study the sleep architecture following stroke and to identify the impact of site, size and severity of ischemic cerebrovascular troke on sleep microstructure. Subjects and methods this was a case control study; polysomnogram was done for 93 patients admitted to the stroke unit at El- Hadara university hospital with the first ever ischemic stroke. NIHSS was calculated immediately and 1 month after stroke onset. 50 age matched control subjects with no evidence of central nervous system or major psychiatric disorder by history or clinical examination. Results Total sleep time, sleep efficiency were lower in ischemic cerebrovascular stroke patients than in control group and this was statistically significant (p = .001* p = .0001* respectively). Arousal index limb movement index and snoring index were all higher among the ischemic cerebrovascular stroke group in comparison to the control group and this was statistically significant (p = .0001*p = .05*p = .0001). Both the REM(rapid eye movement) and REM latency were highest among brain stem stroke, and this was statistically significant p = .043*, p = .0.001*.cortical infarcts showed higher AHI (apnea hypopnea index)and this was statistically significant p = 0.002* Limb movement index was higher among sizable size stroke and this was statistically significant (p = 0.038). NIHSS National Institutes of Health Stroke Scale after 1 month follow up showed a significant indirect correlation with the lowest oxygen saturation during sleep (p = 0.047). Lowest oxygen saturation was lowest among sizable stokes and desaturation index was highest among sizable size strokes both were statistically significant p = 0.006. NIHSS2 had a significant negative correlation with the lowest oxygen saturation during sleep p = 0.047. Conclusion The microstructure of sleep is significantly impacted by cerebrovascular stroke. Brain stem strokes had the highest REM and REM latency, while cortical strokes had the highest moderate-to-severe AHI. Sizable strokes displayed increased indices of limb movement, desaturation, and oxygen saturation.
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spelling doaj.art-87935acd01b744d7a8a69668db8cd1562023-10-29T12:27:43ZengBMCBMC Neurology1471-23772023-10-012311910.1186/s12883-023-03438-6Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic studyJaidaa Mekky0Nadia Hafez1Osama El Kholy2Doaa Elsalamawy3Dina Gaber4Department of Neurology, Faculty of Medicine, Alexandria UniversityDepartment of Neurology, Faculty of Medicine, Alexandria UniversityDepartment of Neurology, Faculty of Medicine, Alexandria UniversityDepartment of Neurology, Faculty of Medicine, Alexandria UniversityDepartment of Neurology, Faculty of Medicine, Alexandria UniversityAbstract Background Sleep difficulties following a cerebrovascular stroke are an interesting topic in the scientific community. Following a brain ischemic insult, a variety of sleep problems can occur. Aim of work To study the sleep architecture following stroke and to identify the impact of site, size and severity of ischemic cerebrovascular troke on sleep microstructure. Subjects and methods this was a case control study; polysomnogram was done for 93 patients admitted to the stroke unit at El- Hadara university hospital with the first ever ischemic stroke. NIHSS was calculated immediately and 1 month after stroke onset. 50 age matched control subjects with no evidence of central nervous system or major psychiatric disorder by history or clinical examination. Results Total sleep time, sleep efficiency were lower in ischemic cerebrovascular stroke patients than in control group and this was statistically significant (p = .001* p = .0001* respectively). Arousal index limb movement index and snoring index were all higher among the ischemic cerebrovascular stroke group in comparison to the control group and this was statistically significant (p = .0001*p = .05*p = .0001). Both the REM(rapid eye movement) and REM latency were highest among brain stem stroke, and this was statistically significant p = .043*, p = .0.001*.cortical infarcts showed higher AHI (apnea hypopnea index)and this was statistically significant p = 0.002* Limb movement index was higher among sizable size stroke and this was statistically significant (p = 0.038). NIHSS National Institutes of Health Stroke Scale after 1 month follow up showed a significant indirect correlation with the lowest oxygen saturation during sleep (p = 0.047). Lowest oxygen saturation was lowest among sizable stokes and desaturation index was highest among sizable size strokes both were statistically significant p = 0.006. NIHSS2 had a significant negative correlation with the lowest oxygen saturation during sleep p = 0.047. Conclusion The microstructure of sleep is significantly impacted by cerebrovascular stroke. Brain stem strokes had the highest REM and REM latency, while cortical strokes had the highest moderate-to-severe AHI. Sizable strokes displayed increased indices of limb movement, desaturation, and oxygen saturation.https://doi.org/10.1186/s12883-023-03438-6StrokeSleepPolysomography
spellingShingle Jaidaa Mekky
Nadia Hafez
Osama El Kholy
Doaa Elsalamawy
Dina Gaber
Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study
BMC Neurology
Stroke
Sleep
Polysomography
title Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study
title_full Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study
title_fullStr Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study
title_full_unstemmed Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study
title_short Impact of site, size and severity of ischemic cerebrovascular stroke on sleep in a sample of Egyptian patients a polysomnographic study
title_sort impact of site size and severity of ischemic cerebrovascular stroke on sleep in a sample of egyptian patients a polysomnographic study
topic Stroke
Sleep
Polysomography
url https://doi.org/10.1186/s12883-023-03438-6
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