中风早期睡眠呼吸暂停治疗（eSATIS）--一项多中心、随机对照、评分者盲法临床试验：中风后认知与睡眠呼吸障碍及其治疗的关系

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research Pub Date : 2024-09-10 DOI:10.1111/jsr.14296

Irina Filchenko, Simone B. Duss, Saskia Salzmann, Anne‐Kathrin Brill, Lyudmila Korostovtseva, Valeria Amelina, Sébastien Baillieul, Corrado Bernasconi, Markus H. Schmidt, Claudio L. A. Bassetti

{"title":"中风早期睡眠呼吸暂停治疗（eSATIS）--一项多中心、随机对照、评分者盲法临床试验：中风后认知与睡眠呼吸障碍及其治疗的关系","authors":"Irina Filchenko, Simone B. Duss, Saskia Salzmann, Anne‐Kathrin Brill, Lyudmila Korostovtseva, Valeria Amelina, Sébastien Baillieul, Corrado Bernasconi, Markus H. Schmidt, Claudio L. A. Bassetti","doi":"10.1111/jsr.14296","DOIUrl":null,"url":null,"abstract":"SummarySleep‐disordered breathing (SDB) is linked to cognitive dysfunction. Although SDB is common in stroke patients, the impact of SDB and its early treatment on cognitive functioning after stroke remains poorly investigated. Therefore, we explored the association between SDB and post‐stroke cognitive functioning, including the impact of early SDB treatment with adaptive servo‐ventilation (ASV) on cognitive recovery from acute event to 3 months post‐stroke. We used data from two studies, which included ischaemic stroke patients (n = 131) and no‐stroke controls (n = 37) without SDB (apnea–hypopnea index, AHI <5/h) and with SDB (AHI≥20/h). Cognitive functioning was assessed within 7 days and 3 months post‐stroke in stroke patients, or at study inclusion in no‐stroke control group, respectively. Stroke patients with SDB were randomized to ASV treatment (ASV+) or usual care (ASV‐). Linear regression adjusted for main confounders assessed the impact of SDB and its treatment on cognitive recovery. The intention‐to‐treat analysis did not show significant associations of SDB ASV+ (n = 30) versus SDB ASV‐ (n = 29) with cognitive recovery. In an exploratory subanalysis, compliant SDB ASV+ (n = 14) versus SDB ASV‐ showed improvements with ASV in visual memory and cognitive flexibility. Combining the stroke and non‐stroke datasets, SDB (n = 85) versus no‐SDB (n = 83) was associated with deficits in visual memory and response inhibition independently of stroke. SDB ASV‐ versus no‐SDB (n = 51) was associated with less improvement in visual memory. There was no substantial evidence for benefits of intention‐to‐treat ASV on cognitive recovery. Exploratory analysis indicated that compliant ASV treatment could benefit visual memory and cognitive flexibility, whereas untreated SDB could contribute to a poor recovery of visual memory.","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":"24 1","pages":"e14296"},"PeriodicalIF":3.4000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early sleep apnea treatment in stroke (eSATIS) – a multicentre, randomised controlled, rater‐blinded, clinical trial: The association of post‐stroke cognition with sleep‐disordered breathing and its treatment\",\"authors\":\"Irina Filchenko, Simone B. Duss, Saskia Salzmann, Anne‐Kathrin Brill, Lyudmila Korostovtseva, Valeria Amelina, Sébastien Baillieul, Corrado Bernasconi, Markus H. Schmidt, Claudio L. A. Bassetti\",\"doi\":\"10.1111/jsr.14296\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"SummarySleep‐disordered breathing (SDB) is linked to cognitive dysfunction. Although SDB is common in stroke patients, the impact of SDB and its early treatment on cognitive functioning after stroke remains poorly investigated. Therefore, we explored the association between SDB and post‐stroke cognitive functioning, including the impact of early SDB treatment with adaptive servo‐ventilation (ASV) on cognitive recovery from acute event to 3 months post‐stroke. We used data from two studies, which included ischaemic stroke patients (n = 131) and no‐stroke controls (n = 37) without SDB (apnea–hypopnea index, AHI <5/h) and with SDB (AHI≥20/h). Cognitive functioning was assessed within 7 days and 3 months post‐stroke in stroke patients, or at study inclusion in no‐stroke control group, respectively. Stroke patients with SDB were randomized to ASV treatment (ASV+) or usual care (ASV‐). Linear regression adjusted for main confounders assessed the impact of SDB and its treatment on cognitive recovery. The intention‐to‐treat analysis did not show significant associations of SDB ASV+ (n = 30) versus SDB ASV‐ (n = 29) with cognitive recovery. In an exploratory subanalysis, compliant SDB ASV+ (n = 14) versus SDB ASV‐ showed improvements with ASV in visual memory and cognitive flexibility. Combining the stroke and non‐stroke datasets, SDB (n = 85) versus no‐SDB (n = 83) was associated with deficits in visual memory and response inhibition independently of stroke. SDB ASV‐ versus no‐SDB (n = 51) was associated with less improvement in visual memory. There was no substantial evidence for benefits of intention‐to‐treat ASV on cognitive recovery. Exploratory analysis indicated that compliant ASV treatment could benefit visual memory and cognitive flexibility, whereas untreated SDB could contribute to a poor recovery of visual memory.\",\"PeriodicalId\":17057,\"journal\":{\"name\":\"Journal of Sleep Research\",\"volume\":\"24 1\",\"pages\":\"e14296\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Sleep Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jsr.14296\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Sleep Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jsr.14296","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

摘要睡眠呼吸障碍（SDB）与认知功能障碍有关。虽然 SDB 在脑卒中患者中很常见，但有关 SDB 及其早期治疗对脑卒中后认知功能的影响的研究仍然很少。因此，我们探讨了 SDB 与脑卒中后认知功能之间的关系，包括使用自适应伺服通气（ASV）早期治疗 SDB 对脑卒中急性期至卒中后 3 个月认知功能恢复的影响。我们使用了两项研究的数据，包括缺血性脑卒中患者（n = 131）和无脑卒中对照组（n = 37），其中无 SDB（呼吸暂停-低通气指数，AHI <5/h）和有 SDB（AHI≥20/h）。脑卒中患者的认知功能分别在脑卒中后 7 天和 3 个月内进行评估，无脑卒中对照组则在纳入研究时进行评估。患有 SDB 的脑卒中患者随机接受 ASV 治疗（ASV+）或常规护理（ASV-）。调整主要混杂因素后的线性回归评估了SDB及其治疗对认知恢复的影响。意向治疗分析结果显示，SDB ASV+（n = 30）与 SDB ASV-（n = 29）与认知恢复的关系并不显著。在一项探索性子分析中，SDB ASV+（n = 14）与 SDB ASV- 相比，ASV 改善了视觉记忆和认知灵活性。综合卒中和非卒中数据集，SDB（n = 85）与无 SDB（n = 83）在视觉记忆和反应抑制方面的缺陷与卒中无关。SDB ASV- 与无 SDB（n = 51）相比，视觉记忆的改善程度较低。没有大量证据表明意向性 ASV 对认知恢复有益。探索性分析表明，遵从 ASV 治疗可使视觉记忆和认知灵活性受益，而未经治疗的 SDB 可导致视觉记忆恢复不佳。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Early sleep apnea treatment in stroke (eSATIS) – a multicentre, randomised controlled, rater‐blinded, clinical trial: The association of post‐stroke cognition with sleep‐disordered breathing and its treatment

SummarySleep‐disordered breathing (SDB) is linked to cognitive dysfunction. Although SDB is common in stroke patients, the impact of SDB and its early treatment on cognitive functioning after stroke remains poorly investigated. Therefore, we explored the association between SDB and post‐stroke cognitive functioning, including the impact of early SDB treatment with adaptive servo‐ventilation (ASV) on cognitive recovery from acute event to 3 months post‐stroke. We used data from two studies, which included ischaemic stroke patients (n = 131) and no‐stroke controls (n = 37) without SDB (apnea–hypopnea index, AHI <5/h) and with SDB (AHI≥20/h). Cognitive functioning was assessed within 7 days and 3 months post‐stroke in stroke patients, or at study inclusion in no‐stroke control group, respectively. Stroke patients with SDB were randomized to ASV treatment (ASV+) or usual care (ASV‐). Linear regression adjusted for main confounders assessed the impact of SDB and its treatment on cognitive recovery. The intention‐to‐treat analysis did not show significant associations of SDB ASV+ (n = 30) versus SDB ASV‐ (n = 29) with cognitive recovery. In an exploratory subanalysis, compliant SDB ASV+ (n = 14) versus SDB ASV‐ showed improvements with ASV in visual memory and cognitive flexibility. Combining the stroke and non‐stroke datasets, SDB (n = 85) versus no‐SDB (n = 83) was associated with deficits in visual memory and response inhibition independently of stroke. SDB ASV‐ versus no‐SDB (n = 51) was associated with less improvement in visual memory. There was no substantial evidence for benefits of intention‐to‐treat ASV on cognitive recovery. Exploratory analysis indicated that compliant ASV treatment could benefit visual memory and cognitive flexibility, whereas untreated SDB could contribute to a poor recovery of visual memory.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Sleep Research 医学-临床神经学

CiteScore

9.00

自引率

6.80%

发文量

234

审稿时长

6-12 weeks

期刊介绍： The Journal of Sleep Research is dedicated to basic and clinical sleep research. The Journal publishes original research papers and invited reviews in all areas of sleep research (including biological rhythms). The Journal aims to promote the exchange of ideas between basic and clinical sleep researchers coming from a wide range of backgrounds and disciplines. The Journal will achieve this by publishing papers which use multidisciplinary and novel approaches to answer important questions about sleep, as well as its disorders and the treatment thereof.