Abstract：Objective To investigate the clinical characteristics of wake-up stroke with sleep disorders.Methods Between June 2016 and March 2018,206 consecutive patients with acute ischemic stroke admitted to the Department of Neurology,the Air Force Medical Center, within 3 days of onset were enrolled. They were divided into the wake-up stroke group (WUS) and the non-wake-up stroke group (NWUS) according to whether the onset time was clear. The demographic information, medical history, and stroke characteristics including severity (National Institutes of Health Stroke Scale,NIHSS), infarction location and mechanism (Trial of Org 10172 in Acute Stroke Treatment criteria TOAST) were collected. The Berlin Questionnaire was used to determine the severity of underlying obstructive sleep apnea (OSA) in the two groups. Sleep duration was categorized into three groups: ≤6 hours/day,7-8 hours/day, and ≥9 hours /day. OSA and sleep duration were compared between the two groups.Results Among the 206 cases, there were 65 cases of WUS and 141 cases of NWUS. WUS and NWUS patients were similar in regard to most of the stroke risk factors, NIHSS and infarction location(P>0.05). The incidence of diabetes among WUS patients was significantly higher than among NWUS ones (55.4% vs. 36.9%, P<0.05). WUS was significantly more likely to result from the small-vessel disease mechanism than NWUS(52.3% vs. 34%,P<0.05). Of the 65 patients with WUS, 42(64.6%) had underlying OSA, compared with 67 (47.5%) of the 141 patients with NWUS(P<0.05). Long sleep duration was more common in patients with WUS than in patients with NWUS (24.6% vs. 10.7%, P<0.05).Conclusions Diabetes is more prevalent among patients with WUS that is more likely to result from the small-vessel disease mechanism. OSA and long sleep duration may contribute to WUS.
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2021, Vol. 32 
