Background and Purpose- Compared with other causes of ischemic stroke, the mechanism of action of embolic stroke of undetermined source (ESUS) remains unclear, with previous literature suggesting that ESUS may be due to an undetected cardioembolic source. This study aimed to improve our understanding of the pathophysiology of ESUS through current knowledge of sleep disorders. Methods- Patients were included in this study if they sustained an ischemic stroke and completed either polysomnography or a home sleep apnea test. Strokes were classified into 1 of 6 mechanisms and were compared with the presence of sleep disorders (ie, obstructive sleep apnea, periodic limb movements, and abnormalities in sleep architecture). Results- There was a significant relationship between obstructive sleep apnea and cardioembolic stroke mechanism compared with the other stroke mechanisms (P=0.018). There was no significant relationship between obstructive sleep apnea and ESUS (P=0.585). Patients with ESUS were significantly more likely to have an elevated periodic limb movement index (P=0.037) and prolonged sleep onset latency (P=0.0166) compared with patients with other causes of stroke. Conclusions- ESUS was not associated with markers of cardioembolic stroke such as obstructive sleep apnea. There was a significant relationship between ESUS and elevated periodic limb movements and impaired sleep architecture, which suggests that ESUS may have a multifactorial underlying pathophysiology.

中文翻译：

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未定来源和睡眠障碍的栓塞性中风。

背景与目的-与其他原因的缺血性卒中相比，未确定来源的栓塞性卒中的作用机制仍不清楚，以前的文献表明，ESUS可能是由于未检测到心脏栓塞源所致。这项研究旨在通过目前的睡眠障碍知识来增进我们对ESUS病理生理的了解。方法-如果患者持续缺血性卒中并完成多导睡眠图或家庭睡眠呼吸暂停试验，则纳入本研究。中风分为6种机制中的1种，并与睡眠障碍（即阻塞性睡眠呼吸暂停，周期性肢体运动和睡眠结构异常）的存在进行比较。结果-与其他卒中机制相比，阻塞性睡眠呼吸暂停与心脏栓塞性卒中机制之间存在显着关系（P = 0.018）。阻塞性睡眠呼吸暂停与ESUS之间无显着相关性（P = 0.585）。与其他中风患者相比，患有ESUS的患者更有可能出现周期性肢体运动指数升高（P = 0.037）和睡眠发作潜伏期延长（P = 0.0166）。结论-ESUS与心脏栓塞性中风的标志物（如阻塞性睡眠呼吸暂停）无关。ESUS与周期性肢体活动增加和睡眠结构受损之间存在显着关系，这表明ESUS可能具有多因素的潜在病理生理学。阻塞性睡眠呼吸暂停与ESUS之间无显着相关性（P = 0.585）。与其他中风患者相比，患有ESUS的患者更有可能出现周期性肢体运动指数升高（P = 0.037）和睡眠发作潜伏期延长（P = 0.0166）。结论-ESUS与心脏栓塞性中风的标志物（如阻塞性睡眠呼吸暂停）无关。ESUS与周期性肢体活动增加和睡眠结构受损之间存在显着关系，这表明ESUS可能具有多因素的潜在病理生理学。阻塞性睡眠呼吸暂停与ESUS之间无显着相关性（P = 0.585）。与其他中风患者相比，患有ESUS的患者更有可能出现周期性肢体运动指数升高（P = 0.037）和睡眠发作潜伏期延长（P = 0.0166）。结论-ESUS与心脏栓塞性中风的标志物（如阻塞性睡眠呼吸暂停）无关。ESUS与周期性肢体活动增加和睡眠结构受损之间存在显着关系，这表明ESUS可能具有多因素的潜在病理生理学。结论-ESUS与心脏栓塞性中风的标志物（如阻塞性睡眠呼吸暂停）无关。ESUS与周期性肢体活动增加和睡眠结构受损之间存在显着关系，这表明ESUS可能具有多因素的潜在病理生理学。结论-ESUS与心脏栓塞性中风的标志物（如阻塞性睡眠呼吸暂停）无关。ESUS与周期性肢体活动增加和睡眠结构受损之间存在显着关系，这表明ESUS可能具有多因素的潜在病理生理学。