Распространенность и характер нарушений дыхания во сне при ишемическом инсульте

Фонякин А.В., Гераскина Л.А., Максимова М.Ю., Лутохин Г.М. Распространенность и характер нарушений дыхания во сне при ишемическом инсульте. CardioСоматика. 2018; 9 (2): 12–16. DOI: 10.26442/2221-7185_2018.2.12-16

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Fonyakin A.V., Geraskina L.A., Maksimova M.Yu., Lutokhin GM. Prevalence and character of sleep-disordered breathing in ischemic stroke. Cardiosomatics. 2018; 9 (2): 12–16. DOI: 10.26442/2221-7185_2018.2.12-16

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Аннотация

В первые 5 сут заболевания 78 пациентам с острым ишемическим инсультом и 20 больным с хроническими цереброваскулярными заболеваниями – дисциркуляторной энцефалопатией и остаточными явлениями нарушений мозгового кровообращения – выполнено кардиореспираторное мониторирование. Синдром нарушения дыхания во сне выявлен у 88% больных с ишемическим инсультом, представлен обструктивным (87% больных) и центральным (13% больных) апноэ. У 1/2 больных с инсультом дыхательные расстройства были умеренными и тяжелыми. Преимущественно центральные апноэ обнаружено только при остром инсульте и ассоциировалось с тяжестью острой неврологической симптоматики.

Ключевые слова: ишемический инсульт, нарушения дыхания во сне.

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78 patients with acute ischemic stroke in the first 5 days of the disease и 20 patients with chronic cerebrovascular diseases – dyscirculatory encephalopathy and residual stage of ischemic stroke, had examined with cardiorespiratory monitoring. Sleep-disordered breathing (SDB) was detected in 88% of patients with ischemic stroke, including obstructive (87% of patients) and central (13% of patients) type. In half of the stroke patients, SDB was moderate and severe. The development of central sleep apnea is associated with the severity of acute neurologic symptoms.

Key words: ischemic stroke, sleep-disordered breathing.

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1. Tsara V et al. Guidelines for Diagnosis and Treatment of Sleep-related Breathing Disorders in Adults and Children. Hippokratia 2009; 13 (3): 187–91.
2. Sviriaev Iu.V. i dr. Prognosticheskoe znachenie sindroma obstruktivnogo apnoe vo sne: promezhutochnye rezul'taty piatiletnego prospektivnogo nabliudeniia. Arterial'naia gipertenziia. 2011; 17 (1): 10–6. [in Russian]
3. Bradley TD, Floras JS. Obstructive sleep apnea and its cardiovascular consequences. Lancet 2009; 373: 82–93.
4. Kent BD et al. Obstructive sleep apnea and inflammation: relationship to cardiovascular comorbidity. Res Physiol Neurobiol 2011; 178: 475–81.
5. Poluektov M.G. i dr. Rasstroistva dykhaniia vo sne pri nevrologicheskoi patologii. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2002; 5 (Insul't): 22–6. [in Russian]
6. Cho ER et al. Obstructive sleep apnea as a risk factor for silent cerebral infarction. J Sleep Res 2013; 4: 452–8.
7. Stahl SM et al. Infarct location and sleep apnea: evaluating the potential association in acute ischemic stroke. Sleep Med 2015; 10: 1198–203.
8. Parra O, Arboix AJ. Stroke and sleep-disordered breathing: A relationship under construction. Clin Cases 2016; 4 (2): 33–7.
9. Sahlin C et al. Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Arch Intern Med 2008; 168: 297–301.
10. Parra O et al. Early treatment of obstructive apnea and stroke outcome: a randomised controlled trial. Eur Respir J 2011; 37: 1128–36.
11. Netzer NC et al. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Int Med 1999; 131 (7): 485–91.
12. Vereshchagin N.V. i dr. Komp'iuternaia tomografiia mozga. M.: Meditsina, 1986. [in Russian]
13. Epstein LJ et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5 (3): 263–76.
14. Drager LF et al. Obstructive sleep apnea, masked hypertension, and arterial stiffness in men. Am J Hypertens 2010; 23: 249–54.
15. Peppard PE et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177 (9): 1006–14.
16. Magomedova N.M., Golukhova E.Z. Slip-apnoe i serdechno-sosudistye riski. Kreativnaia kardiologiia. 2016; 10 (3): 210–9. [in Russian]
17. McNicholas WT, Bonsignore MR. Management Committee of EU COST ACTION B26. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J 2007; 29: 156–78.
18. Garvey JF et al. Epidemiological aspects of obstructive sleep apnea. J Thorac Dis 2015; 5: 920–9.
19. Kernan WN et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45: 2160–236.
20. Brown DL. Brainstem infarction and sleep-disordered breathing in the BASIC sleep apnea study. Sleep Med 2014; 15: 887–91.
21. Johnson KG, Johnson DC. Frequency of Sleep Apnea in Stroke and TIA Patients: A Meta-analysis. J Clin Sleep Med 2010; 6 (2): 131–7.
22. Owens RL et al. Upper airway function in the pathogenesis of obstructive sleep apnea: a review of the current literature. Cur Opin in Pulm Med 2008; 14: 519–24.
23. Epstein LJ et al. Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical Guideline for the Evaluation, Management and Long-term Care of Obstructive Sleep Apnea in Adults. J Clin Sleep Med 2009; 5 (3): 263–76.
24. Poluektov M.G. Diagnostika i lechenie rasstroistv sna. M.: MEDpress-inform, 2016. [in Russian]
25. Matthias M.S. et al. Challenges and motivating factors related to positive airway pressure therapy for post-TIA and stroke patients. Behav Sleep Med 2014; 12: 143–57.

Авторы

А.В.Фонякин*, Л.А.Гераскина, М.Ю.Максимова, Г.М.Лутохин

ФГБНУ «Научный центр неврологии». 125367, Россия, Москва, Волоколамское ш., д. 80
*Fonyakin@mail.ru

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A.V.Fonyakin*, L.A.Geraskina, M.Yu.Maksimova, G.M.Lutokhin

Research Center of Neurology. 125367, Russian Federation, Moscow, Volokolamskoe sh., d. 80
*Fonyakin@mail.ru

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