高压氧舱内同步脑仿生电刺激对脑卒中相关睡眠障碍的效果

doi:10.3969/j.issn.1006-9771.2025.05.001

Abstract

Abstract:

Objective To explore the effect of hyperbaric oxygen combined with synchronous brain bionic electrical stimulation on patients with stroke-related sleep disorders.
Methods From November, 2023 to November, 2024, a total of 68 stroke patients with stroke-related sleep disorders admitted to Huashan Hospital, Fudan University were selected. They were randomly divided into control group (n = 34) and experimental group (n = 34). The control group received routine hyperbaric oxygen therapy, while the experimental group received routine hyperbaric oxygen therapy combined with synchronous brain bionic electrical stimulation inside the chamber, for four weeks. Pittsburgh Sleep Quality Index (PSQI), sleep-monitoring wristbands, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess the outcomes before and after treatment..
Results Four patients in the control group and one in the experimental group dropped out. After treatment, the scores of each factors of PSQI decreased in both groups (t > 2.693, P < 0.05), and were lower in the experimental group than in the control group (t > 2.699, P < 0.01), expect hypnotic drug use (P > 0.05); the total sleep time, deep sleep time and rapid eye movement sleep time became longer in both groups (|t| > 7.270, P < 0.001), and they were longer in the experimental group than in the control group (|t| > 5.712, P < 0.001); the scores of SAS and SDS decreased in both groups (t > 9.530, P < 0.001), and they were less in the experimental group than in the control group (t > 4.740, P < 0.001).
Conclusion Synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber could effectively prolong the total sleep time, deep sleep time and rapid eye movement time of patients with stroke-related sleep disorders, relieve anxiety and depression after stroke, and improve sleep quality.

Key words: stroke, sleep disorders, hyperbaric oxygen therapy, synchronized brain bionic electrical stimulation, emotional disorders

CLC Number:

R743.3

LIANG Dan, WANG Weining, LI Ce, WU Yue, XU Shu, XIE Hongyu, WU Yi, ZHU Yulian. Effect of synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber on stroke-related sleep disorders[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 497-504.

Figures/Tables 4

Table 1

Table 2

Comparison of PSQI scores between two groups pre- and post-treatment"

项目	组别	n	测试	$x - ± s$	t值	P值
睡眠质量	对照组	30	前测	2.50±0.51	7.616	< 0.001
			后测	1.83±0.46
	试验组	33	前测	2.58±0.50	12.736	< 0.001
			后测	1.30±0.47
	治疗前两组均值差			-0.08±0.13	-0.595	0.554
	治疗后两组均值差			0.53±0.12	4.530	< 0.001
入睡时间	对照组	30	前测	2.47±0.51	7.167	< 0.001
			后测	1.77±0.43
	试验组	33	前测	2.52±0.51	17.333	< 0.001
			后测	1.33±0.48
	治疗前两组均值差			-0.05±0.13	-0.379	0.706
	治疗后两组均值差			0.43±0.12	3.765	< 0.001
睡眠时间	对照组	30	前测	2.43±0.50	5.525	< 0.001
			后测	1.77±0.50
	试验组	33	前测	2.48±0.51	25.145	< 0.001
			后测	1.42±0.50
	治疗前两组均值差			-0.05±0.13	-0.404	0.688
	治疗后两组均值差			0.34±0.13	2.699	0.009
睡眠效率	对照组	30	前测	2.43±0.50	7.077	< 0.001
			后测	1.80±0.48
	试验组	33	前测	2.45±0.51	12.000	< 0.001
			后测	1.36±0.49
	治疗前两组均值差			-0.02±0.13	-0.167	0.868
	治疗后两组均值差			0.44±0.12	3.556	0.001
睡眠障碍	对照组	30	前测	2.43±0.50	6.158	< 0.001
			后测	1.87±0.51
	试验组	33	前测	2.52±0.51	10.000	< 0.001
			后测	1.45±0.51
	治疗前两组均值差			-0.08±0.13	-0.641	0.524
	治疗后两组均值差			0.41±0.13	3.225	0.002
催眠药物	对照组	30	前测	1.37±0.49	2.693	0.012
			后测	1.17±0.38
	试验组	33	前测	1.36±0.55	4.000	< 0.001
			后测	1.03±0.17
	治疗前两组均值差			0.003±0.13	0.023	0.982
	治疗后两组均值差			0.14±0.08	1.805	0.079
日间功能障碍	对照组	30	前测	2.40±0.50	4.572	< 0.001
			后测	1.83±0.59
	试验组	33	前测	2.36±0.49	14.977	< 0.001
			后测	1.21±0.42
	治疗前两组均值差			0.04±0.12	0.292	0.771
	治疗后两组均值差			0.62±0.13	4.857	< 0.001
PSQI总分	对照组	30	前测	16.03±1.13	15.502	< 0.001
			后测	12.07±1.46
	试验组	33	前测	16.27±1.35	29.942	< 0.001
			后测	9.12±1.05
	治疗前两组均值差			-0.24±0.32	-0.758	0.451
	治疗后两组均值差			2.95±0.32	9.241	< 0.001

Table 2

Table 3

Comparison of sleep-related indicators between two groups pre- and post-treatment 单位：min"

评价指标	组别	n	测试	$x - ± s$	t值	P值
总睡眠时间	对照组	30	前测	263.33±33.87	-10.359	< 0.001
			后测	311.33±20.97
	试验组	33	前测	264.24±36.83	-9.403	< 0.001
			后测	356.36±39.59
	治疗前两组均值差			-0.91±8.95	-0.102	0.919
	治疗后两组均值差			-45.03±7.88	-5.712	< 0.001
深睡眠时间	对照组	30	前测	57.43±8.05	-7.270	< 0.001
			后测	63.87±7.51
	试验组	33	前测	57.70±7.98	-17.806	< 0.001
			后测	82.76±6.83
	治疗前两组均值差			-0.26±2.02	-0.130	0.897
	治疗后两组均值差			-18.89±1.81	-10.462	< 0.001
快速动眼时间	对照组	30	前测	48.23±8.37	-14.054	< 0.001
			后测	64.53±6.24
	试验组	33	前测	48.67±7.97	-27.262	< 0.001
			后测	80.03±7.43
	治疗前两组均值差			-0.43±2.06	-0.210	0.834
	治疗后两组均值差			-15.50±1.74	-8.918	< 0.001

Table 3

Table 4

Comparison of the scores of SAS and SDS between two groups pre- and post-treatment"

评价指标	组别	n	测试	$x - ± s$	t值	P值
SAS	对照组	30	前测	66.70±2.91	9.530	< 0.001
			后测	57.07±5.93
	试验组	33	前测	66.64±3.68	16.158	< 0.001
			后测	48.33±5.42
	治疗前两组均值差			0.06±0.84	0.076	0.940
	治疗后两组均值差			8.73±1.43	6.106	< 0.001
SDS	对照组	30	前测	66.57±2.24	10.059	< 0.001
			后测	55.63±6.48
	试验组	33	前测	66.55±2.86	20.120	< 0.001
			后测	49.03±4.48
	治疗前两组均值差			0.02±0.65	0.033	0.974
	治疗后两组均值差			6.60±1.39	4.740	< 0.001

Table 4

References 42

[1]	TU W J, ZHAO Z, YIN P, et al. Estimated burden of stroke in China in 2020[J]. JAMA Netw Open, 2023, 6(3): e231455.
[2]	北京神经内科学会睡眠障碍专业委员会,北京神经内科学会神经精神医学与临床心理专业委员会,中国老年学和老年医学学会睡眠科学分会. 卒中相关睡眠障碍评估与管理中国专家共识[J]. 中华内科杂志, 2019, 58(1): 17-26.
	Beijing Neurology Association Sleep Disorder Committee, Beijing Neurology Association Neuropsychiatry and Clinical Psychology Committee, Chinese Association of Geriatric Sleep Science. Chinese expert consensus on the assessment and management of stroke-related sleep disorders[J]. Chin J Inter Med, 2019, 58(1): 17-26.
[3]	CHEN P, WANG W, BAN W, et al. Deciphering post-stroke sleep disorders: unveiling neurological mechanisms in the realm of brain science[J]. Brain Sci, 2024, 14(4): 307.
[4]	CAI H, WANG X P, YANG G Y. Sleep disorders in stroke: an update on management[J]. Aging Dis, 2021, 12(2): 570-585. doi: 10.14336/AD.2020.0707
[5]	SHI R, MENG W, LIU Z, et al. Hyperbaric oxygen therapy for poststroke insomnia: a systematic review and meta-analysis protocol[J]. BMJ Open, 2024, 14(3): e081642.
[6]	CAMPORESI E M, BOSCO G. Mechanisms of action of hyperbaric oxygen therapy[J]. Undersea Hyperb Med, 2014, 41(3): 247-252. pmid: 24984320
[7]	ROSARIO E R, KAPLAN S E, KHONSARI S, et al. The effect of hyperbaric oxygen therapy on functional impairments caused by ischemic stroke[J]. Neurol Res Int, 2018, 2018: 3172679.
[8]	MEHTA V, VASU T S, PHILLIPS B, et al. Obstructive sleep apnea and oxygen therapy: a systematic review of the literature and meta-analysis[J]. J Clin Sleep Med, 2013, 9(3): 271-279. doi: 10.5664/jcsm.2500 pmid: 23493498
[9]	LAUREAU J, PONS C, LETELLIER G, et al. Hyperbaric oxygen in children with cerebral palsy: a systematic review of effectiveness and safety[J]. PLoS One, 2022, 17(10): e0276126.
[10]	NISSIM N R, PHAM D V H, PODDAR T, et al. The impact of gamma transcranial alternating current stimulation (tACS) on cognitive and memory processes in patients with mild cognitive impairment or Alzheimer's disease: a literature review[J]. Brain Stimul, 2023, 16(3): 748-755. doi: 10.1016/j.brs.2023.04.001 pmid: 37028756
[11]	ELYAMANY O, LEICHT G, HERRMANN C S, et al. Transcranial alternating current stimulation (tACS): from basic mechanisms towards first applications in psychiatry[J]. Eur Arch Psychiatry Clin Neurosci, 2021, 271(1): 135-156.
[12]	ZHU X, REN Y, TAN S, et al. Efficacy of transcranial alternating current stimulation in treating chronic insomnia and the impact of age on its effectiveness: a multisite randomized, double-blind, parallel-group, placebo-controlled study[J]. J Psychiatr Res, 2024, 170(2): 253-261.
[13]	MOTAMEDI G K, JELIAZKOV P G, OYEGBILE-CHIDI T O, et al. Transcranial alternating current stimulation (tACS) as a treatment for insomnia[J]. Can J Neurol Sci, 2023, 50(3): 446-449.
[14]	WANG H X, WANG L, ZHANG W R, et al. Effect of transcranial alternating current stimulation for the treatment of chronic insomnia: a randomized, double-blind, parallel-group, placebo-controlled clinical trial[J]. Psychother Psychosom, 2020, 89(1): 38-47.
[15]	中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019[J]. 中华神经科杂志, 2019, 52(9): 710-715.
	Chinese Society of Neurology, Chinese Stroke Society. Diagnostic criteria of cerebrovascular diseases in China (version 2019)[J]. Chin J Neurol, 2019, 52(9): 710-715.
[16]	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2): 103-107.
	LIU X C, TANG M Q, HU L, et al. Reliability and validity of the Pittsburgh Sleep Quality Index[J]. Chin J Psychiatr, 1996, 29(2): 103-107.
[17]	DUNSTAN D A, SCOTT N, TODD A K. Screening for anxiety and depression: reassessing the utility of the Zung Scales[J]. BMC Psychiatry, 2017, 17(1): 329. doi: 10.1186/s12888-017-1489-6 pmid: 28886698
[18]	MARQUEZ-ROMERO J M, MORALES-RAMÍREZ M, ARAUZ A. Non-breathing-related sleep disorders following stroke[J]. Neurologia, 2014, 29(9): 511-516.
[19]	BU X L, LIU C X, FU B. Research progress of the paraventricular thalamus in the regulation of sleep-wake and emotional behaviors[J]. Ibrain, 2022, 8(2): 219-226.
[20]	SARDI N F, PESCADOR A C, TORRES-CHAVEZ K E, et al. Revealing a role of brainstem monoaminergic nuclei on the pronociceptive effect of sleep restriction[J]. Neuropharmacology, 2024, 258:110055.
[21]	MUEHLROTH B E, RASCH B, WERKLE-BERGNER M. Episodic memory consolidation during sleep in healthy aging[J]. Sleep Med Rev, 2020, 52: 101304.
[22]	HASAN F, MUHTAR M S, WU D, et al. Post-stroke insomnia increased the risk of cognitive impairments: a hospital-based retrospective cohort study[J]. Behav Sleep Med, 2023, 21(6): 802-810
[23]	ZENG Y, CAO S, YANG H. Circulating sex hormone-binding globulin levels and ischemic stroke risk: a mendelian randomization study[J]. Postgrad Med J, 2023, 99(1178): 1272-1279. doi: 10.1093/postmj/qgad083 pmid: 37742091
[24]	MORGAN E, SCHUMM L P, MCCLINTOCK M, et al. Sleep characteristics and daytime cortisol levels in older adults[J]. Sleep, 2017, 40(5): zsx043.
[25]	SIENEL R I, MAMRAK U, BILLER J, et al. Inhaled nitric oxide suppresses neuroinflammation in experimental ischemic stroke[J]. J Neuroinflammation, 2023, 20(1): 301.
[26]	IRWIN M R, OLMSTEAD R, CARROLL J E. Sleep disturbance, sleep duration, and inflammation: a systematic review and meta-analysis of cohort studies and experimental sleep deprivation[J]. Biol Psychiatry, 2016, 80(1): 40-52.
[27]	BAYLAN S, GRIFFITHS S, GRANT N, et al. Incidence and prevalence of post-stroke insomnia: a systematic review and meta-analysis[J]. Sleep Med Rev, 2020, 49(2): 101222.
[28]	SCARELLA T M, BOLAND R J, BARSKY A J. Illness anxiety disorder: psychopathology, epidemiology, clinical characteristics, and treatment[J]. Psychosom Med, 2019, 81(5): 398-407. doi: 10.1097/PSY.0000000000000691 pmid: 30920464
[29]	BHATT S, DEVADOSS T, MANJULA S N, et al. 5-HT₃ receptor antagonism a potential therapeutic approach for the treatment of depression and other disorders[J]. Curr Neuropharmacol, 2021, 19(9): 1545-1559.
[30]	DA CUNHA L L, FETER N, ALT R, et al. Effects of exercise training on inflammatory, neurotrophic and immunological markers and neurotransmitters in people with depression: a systematic review and meta-analysis[J]. J Affect Disord, 2023, 326: 73-82.
[31]	WALKER J M, MULATYA C, HEBERT D, et al. Sleep assessment in a randomized trial of hyperbaric oxygen in U.S. service members with post concussive mild traumatic brain injury compared to normal controls[J]. Sleep Med, 2018, 51: 66-79. doi: S1389-9457(18)30309-5 pmid: 30099354
[32]	WU X, ZHANG S, MA L, et al. Effects of hyperbaric oxygen therapy combined with music therapy on brain function and mental health of patients with aneurismal subarachnoid hemorrhage: a retrospective study[J]. Noise Health, 2024, 26(122): 259-265. doi: 10.4103/nah.nah_19_24 pmid: 39345062
[33]	LIANG X X, HAO Y G, DUAN X M, et al. Hyperbaric oxygen therapy for post-stroke depression: a systematic review and meta-analysis[J]. Clin Neurol Neurosurg, 2020, 195: 105910.
[34]	GUO H, GE Y R, DONG Y B, et al. Effect of hyperbaric oxygen on post-stroke depression[J]. World J Psychiatr, 2023, 13(5): 226-233.
[35]	YAN D, SHAN J, ZE Y, et al. The effects of combined hyperbaric oxygen therapy on patients with post-stroke depression[J]. J Phys Ther Sci, 2015, 27(5): 1295-1297. doi: 10.1589/jpts.27.1295 pmid: 26157204
[36]	BEYNON C, KIENING K L, ORAKCIOGLU B, et al. Brain tissue oxygen monitoring and hyperoxic treatment in patients with traumatic brain injury[J]. J Neurotrauma, 2012, 29(12): 2109-2123.
[37]	FISCHER I, BARAK B. Molecular and therapeutic aspects of hyperbaric oxygen therapy in neurological conditions[J]. Biomolecules, 2020, 10(9): 1247.
[38]	CAO H, TAN X, LIU Z, et al. The effect of adding transcranial direct current stimulation to hyperbaric oxygen therapy in patients with delayed encephalopathy after carbon monoxide poisoning: a randomised controlled trial[J]. Front Neurol, 2021, 12: 719765.
[39]	XIE W, CHEN X, MA X, et al. Effect of hyperbaric oxygen therapy combined with repetitive transcranial magnetic stimulation on vascular cognitive impairment: a randomised controlled trial protocol[J]. BMJ Open, 2023, 13(11): e073532.
[40]	王璐, 高晓平, 宋娟, 等. 脑电仿生电刺激对脑梗死后认知功能障碍的影响[J]. 中国实用神经疾病杂志, 2020, 23(1): 6-10.
	WANG L, GAO X P, SONG J, et al. The effects of electroencephalograph bionic electrical stimulation on cognitive ability in patients with cognitive impairment after ischemic stroke[J]. Chin J Pract Nerv Dis, 2020, 23(1): 6-10.
[41]	段茜, 刘文颖, 金维, 等. 高压氧同步舱内脑电仿生电刺激对脑梗死恢复期患者功能障碍的疗效[J]. 神经病学与神经康复学杂志, 2018, 14(3): 135-140.
	DUAN Q, LIU W Y, JIN W, et al. Effect of synchronized bionic electrical stimulation in hyperbaric oxygen chamber on patients with cerebral infarction in convalescent period[J]. J Neurol Neurorehabil, 2018, 14(3): 135-140.
[42]	董铭杰, 薛瑞君, 王平, 等. 高压氧舱内同步脑仿生电刺激治疗突发性耳聋的疗效及血液流变学变化[J]. 中华航海医学与高气压医学杂志, 2022, 29(1): 61-64.
	DONG M J, XUE R J, WANG P, et al. Curative effect of synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber on patients with sudden deafness and the hemorheological indictors' changes[J]. Chin J Nautical Med Hyperbaric Med, 2022, 29(1): 61-64.

组别	n	性别(男/女)/n	年龄/岁	脑卒中病程/月	体质量指数/(kg·m^-2)
对照组	30	17/13	55.03±9.42	2.29±0.79	24.75±1.74
试验组	33	18/15	55.33±7.22	2.43±0.80	24.95±1.76
χ²/t值		0.029	0.143	0.715	0.442
P值		0.866	0.887	0.477	0.660

Effect of synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber on stroke-related sleep disorders

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 42

Related Articles 15

Metrics

Comments

Recommended 0

[1]	BAI Min, CAO Lihua, YE Ziqi, ZHOU Dingjie, LI Xueping. Effect of electromyographic perception-assisted robotic training combined with paired association stimulation on upper limb function in hemiplegic patients after stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 505-512.
[2]	ZOU Congcong, WANG Xiaojun, MA Jinrong, LU Shangbo, DING Yong, WANG Hani, SONG Jianfei. Effect of transcutaneous auricular vagus nerve stimulation combined with dual-task training on upper limb function in patients with ischemic stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 513-519.
[3]	SHI Bin, XU Ning, ZHOU Guangxue. Application of mirror therapy in motor function rehabilitation for stroke: a bibliometric analysis from 2005 to 2024 [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 561-572.
[4]	CHEN Mengye, QU Qingming, ZHU Jie, CHEN Xianggui, JIA Jie. Characteristics of cardiorespiratory fitness in patients with post-stroke hemiplegia based on cardiopulmonary exercise testing [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 441-447.
[5]	LI Xinlei, WEI Wei, SONG Jian, ZHAO Yuqing, KONG Weicheng, CAI Jiayu, SHI Haoran, XUE Xiehua. Application of resting-state electroencephalography in assessment of upper limb motor function of stroke patients [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 448-457.
[6]	LIU Pengcheng, QU Mengjian, LONG Liping, WANG Yalin, YANG Mingzhu, LIU Peiyong, ZHOU Jun, LIU Jing. Effect of pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 458-465.
[7]	SU Panpan, YE Peng, LU Qian, HE Chuan, LU Xiao. Effect of visual deprivation training combined with proprioceptive training on balance in hemiplegic patients after stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(3): 254-263.
[8]	LIN Changsheng, CAO Yu, WANG Tong, DAI Wenjun, HOU Hong, HU Cuiqin, BAO Shilei, PANG Sufang. Effect of closed-chain exercise training on hemiplegic shoulder pain and shoulder joint stability in stroke patients: a study with ultrasound [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(3): 264-273.
[9]	WANG Xiaojun, WANG Hani, YU Hong, LI Yuanmei, ZHOU Yuda. Effect of high-definition transcranial direct current stimulation combined with upper limb robot on upper limb dysfunction after ischemic stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(2): 218-224.
[10]	MA Wenwen, WEN Yanzheng, Manripati ROZI, CUI Boya, Suyinqimei . Effect of healthy side tilt training on balance function in patients with Pusher syndrome after stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(2): 225-230.
[11]	QIN Qing, LIU Ye, YE Haiyan, LI Chen, CHEN Di. Robot-assisted therapy for upper limb of stoke: a bibliometrics analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(1): 85-98.
[12]	ZHANG Lu, MA Jiangping, YANG Erli, CHEN Qiuhua, DONG Lijun, YIN Xiaobing. Application of cognitive-motor dual-task training in stroke: a bibliometrics analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(9): 1034-1042.
[13]	LUO Hong, XU Li. Effect of repetitive transcranial magnetic stimulation combined with repetitive peripheral magnetic stimulation on upper extremities motor function in patients with cerebral hemorrhage: a randomized controlled trial based on resting state-functional magenetic resonance imaging [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(9): 1060-1068.
[14]	WANG Min, FANG Lantian, HUANG Chenyi. Effect of modified graded motor imagery on upper limb motor function for stroke patients: a randomized controlled trial [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(9): 1069-1073.
[15]	XIE Dandan, CHEN Shanjia, LEI Lei, YU Guo, YU Jiahui, ZHAO Jiapei, HE Xiaokuo. Characteristics of brain activation during treadmill walking with visual feedback in healthy subjects and hemiplegic patients: a functional near infrared spectroscopy study [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(9): 1074-1081.