Study On Risk Factors And Clinical Characteristics Of Sleep Quality Decline After Acute Ischemic Stroke

Background and objectiveWith the improvement of people’s life,the incidence of stroke has increased year by year,and its high incidence and high disability rate have made it the first disease threatening human health,the decline of sleep quality is a common problem after stroke,which is concerned by many factors,such as delayed rehabilitation,aggravating other complications and decreasing quality of life.Due to the many influencing factors that lead to the decline of sleep quality,including the direct injury of ischemia and hypoxia after stroke,it may lead to sleep problems in patients,while the disease leads to emotional fluctuations,psychological changes such as anxiety and depression,and environmental factors such as hospitalization may also affect the quality of sleep of patients.Although the incidence of sleep problems in patients with acute ischemic stroke is high in the clinic,the number of patients who are truly valued and treated is low.This article discusses the incidence of acute ischemic stroke sleep quality decline and the potential risk factors that may lead to its occurrence by collecting stroke-related data in clinical patients,and analyzes the clinical characteristics of patients with acute ischemic stroke combined with decreased sleep quality,to provide relevant theoretical support for the early detection,standardized diagnosis and treatment,and improvement of prognosis of acute ischemic stroke sleep quality decline.MethodsAcutely ischemic stroke patients hospitalized in the first district of the Department of Neurology of Jiaozuo Hospital from March 2022 to December 2022 were continuously collected,screened according to the inclusion and exclusion criteria,and a total of 151 patients who met the criteria were included,and the Pittsburgh Sleep Index Scale was used to evaluate,with 7 as the dividing line,the definition score ≥ 7 into the sleep quality decline group,and the score < 7 into the normal sleep quality group.Record the data of the enrolled patients,including general information(gender,age,education level,marriage history,smoking history,drinking history,etc.),past medical history(hypertension,coronary heart disease,diabetes,hyperlipidemia),and record the blood test results(blood lipids,liver and kidney function,blood homocysteine,etc.)after admission,imaging data(infarct site,infarct hemisphere),and assessment of the degree of neurological impairment(National Institute of Health stroke scale,NIHSS score),daily living ability test(Barthel index),comparing the differences in various data between the two groups.SPSS25.software was used to perform statistical analysis on all data,and P<0.05 was statistically significant considering the difference.Results1.The incidence of sleep quality decline after acute ischemic stroke is high,the results of this study show that the incidence is 56.3%,and the sleep process of patients in the sleep quality reduction group shows an overall decrease,which is manifested as an increase in the latency period of falling asleep,a shortening of sleep duration,and a decrease in sleep efficiency.2.Demographic data analysis: There was no significant significance in age,BMI,smoking history,drinking history,marriage history coronary heart disease,and hyperlipidemia between the group with decreased sleep quality after acute ischemic stroke and the normal sleep quality group(P>0.05).There were significant differences in gender,education level,hypertension and diabetes history(P<0.05).3.Analysis of blood biochemical data: There were no significant differences in hemoglobin(Hb),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),glutamyl aminotransferase(AST),blood urea nitrogen(BUN),creatinine(Cr),and blood homocysteine(Hcy)between the group with decreased sleep quality after acute ischemic stroke and the group with normal sleep quality(P>0.05).4.Analysis of imaging data: the incidence of decreased sleep quality after acute ischemic stroke group and normal sleep quality group in different infarct sites was different,and the incidence of decreased sleep quality was the highest in patients with brainstem infarction(73.5%),followed by subcortical stroke(57.9%),cerebral cortical stroke(52.50%),and cerebellar stroke(30.0%),and there were differences in the effects of different infarct sites on sleep quality.The difference between groups was statistically significant(P<0.05),but the effect of different infarcted hemispheres on sleep quality was not statistically significant(P>0.05).5.Analysis of the degree of neurological impairment and daily living ability: There was a statistically significant difference in NIHSS scores and Barthel index between the group with decreased sleep quality after acute ischemic stroke and the group with normal sleep quality(P<0.05).6.Multivariate Logistic Regression Analysis: The results showed history of diabetes mellitus(OR=2.327,95% CI: 1.070-5.061,P=0.033),NIHSS score≥5 points(OR=7.429,95% CI: 1.416-38.963,P=0.018),dependent group(OR=3.162,95% CI: 1.317-7.590,P=0.010),brainstem stroke(OR=4.199,95% CI: 1.064-16.564,P=0.040)is a risk factor for decreased sleep quality after acute ischemic stroke.Conclusions1.Patients with acute ischemic stroke are prone to decreased sleep quality.2.Patients with a history of diabetes mellitus,the location of stroke in the brain stem,the severity of neurological impairment,and the ability of daily living were at higher risk of poor sleep quality.