Clinical and treatment of post-stroke sleep disorders

  A. The typical clinical manifestations of post-stroke sleep disorders are: 1. Insomnia: refers to problems with the quality and quantity of sleep, i.e., difficulty falling asleep, difficulty maintaining sleep, and causing daytime discomfort (weakness, fatigue, lack of mental concentration, emotional instability, irritability).  2.Excessive sleep: prolonged sleep, too much sleep or too much deep sleep, manifested as prolonged sleep at night or increased sleep during the day.  3.Disrupted sleep cycle: Patients with cerebrovascular disease may have multiple sleeps as in infancy, or reversed day and night sleep.  4, heterogeneous sleep: refers to various abnormalities in sleep, such as: nightmares, sleep talk, night terrors, periodic movements in sleep, etc. Studies have found that cerebral infarction in the thalamus, temporal, parietal and occipital areas can lead to excessive dreaming, cyclic nightmares or confusion between dreams and reality; patients with occipital, deep frontal, thalamic and parietal brain injury can experience temporary or permanent reduction in dreams and dream recall.  (1) For insomnia or abnormalities in sleep, drug therapy is available: commonly used are sedative-hypnotic drugs. Commonly used are: Sulezapine, Synthroid.  (2) For patients with mood disorders should be given antidepressants, anti-anxiety drugs, such as: pentothal reuptake inhibitors.  (3) For excessive sleepers can be given drugs to stimulate the central nervous system: commonly used drugs are mainly amphetamine-type stimulants (monoamine releasing agents), modafinil and levodopa, etc.  (4) In addition, our unique treatment of Chinese medicine and acupuncture can also help some stroke patients, and can even obtain good results.  2.Psychotherapy Good psychological treatment can make patients understand their disease correctly and arouse their positive emotion, which can sometimes achieve better results with drug treatment.  3.Rehabilitation Strengthening rehabilitation treatment, improving patients’ limb movement disorders, muscle ankylosis, etc. and reducing patients’ various discomfort is the basic guarantee for improving sleep.  4.Improve sleep hygiene and sleep environment Develop good sleep habits, achieve regular sleep and wake up, avoid excessive mental stimulation, excessive hunger, excessive satiety, and avoid using drugs and food and drinks that have an impact on the mind before going to bed. Ensure that the sleep environment is comfortable, with appropriate temperature and humidity, soft light and no noise. In addition, you should not neglect to wake up regularly in the morning and ensure 1-2 hours of walking in the sunshine every day.