脑卒中相关性失眠的研究进展

Study on the Progress of Stroke-Related Insomnia

摘要: 脑卒中相关性失眠是卒中后常见的睡眠问题，包括卒中后新发失眠及原有失眠加重。研究表明，脑卒中与失眠之间存在双向作用：卒中可通过脑损伤、炎症反应和情绪障碍等诱发失眠，而长期失眠又可通过神经内分泌失调、交感神经兴奋及炎症激活等加重脑血管损伤，增加卒中发生和复发风险。卒中后失眠不仅发生率较高，还与功能恢复不良、认知和情绪障碍及生活质量下降密切相关。目前其临床识别、机制研究和治疗策略仍存在不足。本文对脑卒中相关性失眠的研究进展作一综述，为临床早期识别和干预提供参考。

Abstract: Stroke-related insomnia is a common sleep disturbance following stroke, encompassing both new-onset insomnia after stroke and the exacerbation of pre-existing insomnia. Accumulating evidence indicates a bidirectional interaction between stroke and insomnia: stroke may precipitate insomnia through mechanisms such as brain injury, neuroinflammatory responses, and emotional disturbances, whereas chronic insomnia can, in turn, aggravate cerebrovascular damage via neuroendocrine dysregulation, heightened sympathetic activation, and inflammatory cascades, thereby increasing the risk of both incident and recurrent stroke. Post-stroke insomnia not only exhibits a high prevalence but is also closely associated with impaired functional recovery, cognitive and affective disorders, and diminished quality of life. Currently, challenges persist in its clinical recognition, mechanistic elucidation, and therapeutic management. This article reviews recent advances in research on stroke-related insomnia, aiming to provide a reference for early clinical identification and intervention.