Διαταραχές ύπνου προ και μετά ΑΕΕ (Master thesis)

Νουβάκης, Δημήτριος

Introduction: Sleep disorders (including sleep-disordered breathing and sleep-wake cycle disturbances) are highly prevelant in stroke patients. They can be both a risk factor for stroke and a consequence of stroke. The mechanisms of this relationship are various and complex, although they are not completely understood. More welldesigned studies are needed in order to obtain more knowledge regarding pathophysiology, the strength of this interaction, and the effect that treatment of these sleep disorders has on the long term management of stroke patients. Methods: Review of the literature. Results: Several studies have proven that Obstructive Sleep Apnea (OSA) is an independent risk factor for the development of stroke and also has a high prevalence (>50%) among stroke patients. Because of that, the AHA/ASA (American Stroke Association) guidelines recommend the use of diagnostic tools (use of questionnaires, polysomnography) in order to detect the presence of OSA in stroke patients. (Class IIb, Level of evidence B). Furthermore it is also recommended that all stroke patients with OSA should be treated with CPAP (Class IIb, Level of Evidence B) however the effect of treatment on prevention of stroke is not well established. Central Sleep Apnea (CSA) on the other hand is mainly a consequence of stroke and its role as a risk factor is not yet known. It appears in the acute setting of stroke and it tends to resolve in the chronic phase. Recently, stroke-wake cycle disturbances (Restless Leg Syndrome, insomnia, hypersomnia, parasomnias, narcolepsy and abnormal duration of sleep) have also been studied regarding their relationship with stroke. They seem to increase the risk of stroke or appear as a result of it. They may also have a negative impact on stroke recovery and re-occurrence. Treatment of these disorders with appropriate medications, such as hypnotics (insomnia), CNS stimulants (hypersomnia), dopaminergic replacement (RLS) and clonazepam (parasomnias) has been studied through single case studies or small case series and therefore its benefit in stroke prevention has been not established. Conclusion: Sleep disorders are an important risk factor for stroke, as well as a frequent finding after stroke and they can have a negative impact on functional and cognitive status, although they are frequently under-recognized. It is therefore important to implement diagnostic and therapeutic tools in order to better manage this difficult group of stroke patients.
Alternative title / Subtitle: ανασκόπηση της βιβλιογραφίας
Institution and School/Department of submitter: Δημοκρίτειο Πανεπιστήμιο Θράκης. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Cerebrovascular disease
Keywords: Διαταραχές ύπνου,Αγγειακό εγκεφαλικό επεισόδιο,ΑΕΕ,Κεντρικό νευρικό σύστημα,Stroke,Sleep disorders,Central nervous system
URI: https://repo.lib.duth.gr/jspui/handle/123456789/11161
http://dx.doi.org/10.26257/heal.duth.9947
Appears in Collections:Π.Μ.Σ. ΑΓΓΕΙΑΚΑ ΕΓΚΕΦΑΛΙΚΑ ΕΠΕΙΣΟΔΙΑ

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https://repo.lib.duth.gr/jspui/handle/123456789/11161
http://dx.doi.org/10.26257/heal.duth.9947
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