The Relationship of Stroke and Sleep-A Review

Ischemic stroke appears the third leading cause of mortality and the first cause of disability in developing countries. The relationship between sleep disorders and cerebrovascular risk factors is well defined and there are different mechanisms in pathophysiology. Ischemic stroke affects many pathways, such as hypoxia, increased wakefulness reactions, decreased sleep quality, increased free oxygen radicals, inflammatory mechanisms activation, endothelial dysfunction, atherosclerosis, hypertension, and insulin resistance. Sleep disturbances contribute to stroke pathology through multiple direct or indirect mechanisms. Due to the fact that sleep disorders are among the changeable cerebrovascular risk factors, it is very important to raise awareness about the diagnosis, management and prevention of sleep disorders

Evaluation of Cognitive Function Using Objective and Subjective Tests in the Obstructive Sleep Apnea Syndrome

Objective: The primary and secondary consequences which related to obstructive respiration to occur during sleep cause cognitive, emotional and behavioral changes indirectly. Aim of the present study was to evaluate quality of sleep and relationship between quality of sleep and cognitive function at baseline and during treatment in the patients having diagnosis of severe Obstructive Sleep Apnea syndrome (OSAS) being followed in sleep laboratory. Materials and Methods: Pittsburg, Epworth and Stroop tests to assess patient attention; P300 test was applied for the evaluation of memory and attention. Results: When the pre-treatment and post-treatment cognitive functions of the patients were compared; there was a significant decrease in daytime sleepiness after treatment (p=0.000) and a significant improvement in latency of P300 test (p=0.000-p=0.001-p=0.004). In Pittsburgh study; the pre-treatment total sleep quality scores were consistent with poor sleep quality, while the mean value obtained after treatment was found to be related to the healthy sleepiness (p=0.000). In the Stroop test for measuring attention, the rate of error correction obtained after treatment was significantly improved (p=0.010). Conclusion: In patients diagnosed with severe OSAS; the negative effects of disease on attention, alertness, and memory, challenges on maintaining the attention and its negative effects on the structure of sleep has been shown by using Stroop, Pittsburgh, P300 and Epworth tests unlike other publications. As a result of the tests performed after the treatment, the fact that it is an important development in the disease shows us how the treatment is important and necessary

Comparison of clinical features in patients with vestibular migraine and migraine

Vestibular migraine (VM) is accepted as the most common cause of spontaneous episodic vertigo. In most patients, vestibular symptoms follow migraine headaches that begin earlier in life. The aim of this multicenter retrospective study was to find out the differences between migraine patients without any vestibular symptoms (MwoV) and VM patients and to delineate the specific clinical features associated with VM. MwoV and VM patients were compared regarding demographic features, migraine headache years, headache attack frequency, intensity, symptoms associated with headache and vertigo attacks, presence of menopause, history of motion sickness and family history of migraine. Four-hundred and forty patients with MwoV and 408 patients with VM were included in the study. Migraine with aura was more frequent in patients with MwoV (p = 0.035). Migraine headache years was longer (p < 0.001) and headache intensity was higher in patients with VM (p = 0.020). Aural fullness/tinnitus was more common in patients with VM (p < 0.001) when all other associated symptoms were more frequent in patients with MwoV (p < 0.001) as well as attack triggers (p < 0.05). Presence of menopause and motion sickness history was reported more frequently by VM patients (p < 0.001). Logistic regression analysis indicated that longstanding history of migraine with severe headache attacks, aural fullness/tinnitus accompanying attacks, presence of menopause, previous motion sickness history were the differentiating clinical features of patients with VM