Objective To investivate the effects of VocaStim?-Master electrical stimulation and pharyngeal muscles training on sleep breathing parameters, clinical symptoms and cognitive functions in stroke patients with obstructive sleep apnea syndrome (OSAS). Methods From December 1st, 2014 to November 30th, 2017, 50 stroke patients complicated with OSAS were divided into control group (n = 25) and research group (n = 25). All the patients received routine medicine and rehabilitation, while the research group accepted VocaStim?-Master electrical stimulation and pharyngeal muscles training in addition, for four weeks. Their symptoms were observed, and tested with polysomnography (PSG) and Mini-Mental State Examination (MMSE) before and after treatment.Results After treatment, the clinical symptoms improved (P < 0.05), while apnea hypopnea index (AHI) (t > 2.270, P < 0.05)and oxygen desaturation index (t > 3.044, P < 0.01) decreased, and average oxygen saturation (SaO2) and lowest SaO2 increased (t > 3.095, P < 0.01), in the research group, compared with those before treatment and those in the control group (P < 0.05), the scores of MMSE increased (t > 2.859, P < 0.01). There was no significant difference of AHI, averge SaO2, lowest SaO2 and oxygen desaturation index during the period of treatment in the control group (P > 0.05), nor for the score of MMSE.Conclusion VocaStim?-Master electrical stimulation combined with pharyngeal muscles training could effectively ameliorate nocturnal sleep apnea symptom and improve cognitive functions in stroke patients complicated with OSAS.
WANG Bi-lei
,
XIA Yang
,
MA Ming
,
YANG Xi
,
LIU Jin
,
LU Xue-song
,
HUANG Jia
,
LIU Nai-feng
. Effects of Electrical Stimulation and Pharyngeal Muscles Training on Obstructive Sleep Apnea Syndrome in Patients with Stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2018
, 24(11)
: 1324
-1328
.
DOI: 10.3969/j.issn.1006-9771.2018.11.013
[1] King S, Cuellar N.Obstructive sleep apnea as an independent stroke risk factor: a review of the evidence, stroke prevention guidelines, and implications for neuroscience nursing practice[J]. J Neurosci Nurs, 2016, 48(3): 133-142.
[2] Li M, Hou WS, Zhang XW, et al.Obstructive sleep apnea and risk of stroke: a meta-analysis of prospective studies[J]. Int J Cardiol, 2014, 172(2): 466-469.
[3] Young T, Finn L, Peppard PE, et al.Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort[J]. Sleep, 2008, 31(18): 1071-1078.
[4] Dumitrascu R, Tiede H, Rosengarten B, et al.Obstructive sleep apnea and stroke[J]. Pneumologie, 2012, 66(8): 476-479.
[5] Lisabeth LD, Scheer RV, Li C, et al.Intracerebral hemorrhage and sleep-disordered breathing[J]. Sleep Med, 2018, 46: 114-116.
[6] Schipper MH, Jellema K, Rijsman RM.Occurrence of obstructive sleep apnea syndrome in patients with transient ischemic attack[J]. J Stroke Cerebrovasc Dis, 2016, 25(5): 1249-1253.
[7] Pengo MF, Xiao S, Ratneswaran C, et al.Randomised sham controlled trial of transcutaneous electrical stimulation in obstructive sleep apnoea[J]. Thorax, 2016, 71(10): 923-931.
[8] 谭杰文,龙颖,邓宝雯,等. 高压氧治疗并咽部神经肌肉电刺激对阻塞性睡眠呼吸暂停综合征的疗效观察[J]. 中国康复医学杂志, 2013, 28(11): 1205-1209.
[9] 中华医学会第四届脑血管病学术会议. 各类脑血管病疾病诊断要点[J]. 中华神经科杂志, 1996, 29(6): 379-380.
[10] Johnson KG, Johnson DC.Frequency of sleep apnea in stroke and TIA patients: a meta-analysis[J]. J Clin Sleep Med, 2010, 6(2): 131-137.
[11] Lutohin GM, Geraskina LA, Fonyakin AV.Sleep-disordered breathing syndrome in acute ischemic stroke[J]. Zh Nevrol Psikhiatr Im S S Korsakova, 2016, 116(12. Vyp. 2): 14-20.
[12] Mansukhani MP, Bellolio MF, Kolla BP, et al.Worse outcome after stroke in patients with obstructive sleep apnea: an observational cohort study[J]. J Stroke Cerebrovasc Dis, 2011, 20(5): 401-405.
[13] Lyons OD, Ryan CM.Sleep apnea and stroke[J]. Can J Cardiol, 2015, 31(7): 918-927.
[14] 阻塞性睡眠呼吸暂停与卒中诊治专家共识组. 阻塞性睡眠呼吸暂停与卒中诊治专家共识[J]. 中华内科杂志, 2014, 53(8): 657-664.
[15] Martínez-García MÁ, Soler-Cataluña JJ, Ejarque-Martínez L, et al.Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow-up study[J]. Am J Respir Crit Care Med, 2009, 180(1): 36-41.
[16] Aaronson JA, Hofman WF, Van Bennekom CAM, et al.Effects of continuous positive airway pressure on cognitive and functional outcome of stroke patients with obstructive sleep apnea: a randomized controlled trial[J]. J Clin Sleep Med, 2016, 12(4): 533-541.
[17] McEvoy RD, Antic NA, Heeley E, et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea[J]. N Engl J Med, 2016, 375(10): 919-931.
[18] Tan JW, Qi WW, Ye RX, et al.Electrical stimulation therapy improves sleep respiratory parameters in obstructive sleep apnea syndrome: a meta-analysis[J]. J Huazhong Univ Sci Technolog Med Sci, 2013, 33(5): 623-627.
[19] Paul B, Durand DM.Effects of selective hypoglossal nerve stimulation on canine upper airway mechanics[J]. J Appl Physiol (1985), 2005, 99(3): 937-943.
[20] Bender B.Upper airway stimulation in OSA[J]. Laryngorhinootologie, 2016, 95(11): 795-807.
[21] Strollo PJ Jr, Soose RJ, Maurer JT, et al.Upper-airway stimulation for obstructive sleep apnea[J]. N Engl J Med, 2014, 370(2): 139-149.
[22] Zhu Z, Hofauer B, Wirth M, et al.Selective upper airway stimulation in older patients[J]. Respir Med, 2018, 140: 77-81.
[23] Patil SP, Schneider H, Marx JJ, et al.Neuromechanical control of upper airway patency during sleep[J]. J Appl Physiol (1985), 2007, 102(2): 547-556.
[24] Giannasi LC, Matsui MY, Freitas SR, et al.Effects of neuromuscular electrical stimulation on the masticatory muscles and physiologic sleep variables in adults with cerebral palsy: a novel therapeutic approach[J]. PLoS One, 2015, 10(8): 0128959.
[25] Martínez-García MA, Galiano-Blancart R, Soler-Cataluña JJ, et al.Improvement in nocturnal disordered breathing after first-ever ischemic stroke: role of dysphagia[J]. Chest, 2006, 129(2): 238-245.
