arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2021-27-5-488-498arthyper-2125Research ArticleСтатьиArticlesГиперсомния и избыточная дневная сонливость при ишемическом инсультеHypersomnia and excessive daytime sleepiness in ischemic strokehttps://orcid.org/0000-0002-0074-4021ТерновыхИ. К.TernovykhI. K.

Терновых Иван Константинович — аспирант, ассистент кафедры неврологии и психиатрии, лаборант-исследователь научно-исследовательской лаборатории неврологии и нейрореабилитации

ул. Аккуратова, д. 2, Санкт-Петербург,197341

Ivan K. Ternovykh, MD, Postgraduate Student, Assistant, Department of Neurology and Psychiatry, Assistant Researcher, Research Department of Neurology and Neurorehabilitation

2 Akkuratov street, St Petersburg, 197341

ternovykh_ik@almazovcentre.ruhttps://orcid.org/0000-0002-4441-1165АлексееваТ. М.AlekseevaT. M.

Алексеева Татьяна Михайловна — доктор медицинских наук, доцент, заведующая кафедрой неврологии и психиатрии, главный научный сотрудник научно-исследовательской лаборатории неврологии и нейрореабилитации

ул. Аккуратова, д. 2, Санкт-Петербург,197341

Tat’yana M. Alekseeva, MD, PhD, DSc, Associate Professor, Head, Department of Neurology and Psychiatry, Main Researcher, Research Department of Neurology and Neurorehabilitation

2 Akkuratov street, St Petersburg, 197341

atmspb@mail.ruhttps://orcid.org/0000-0001-7585-6012КоростовцеваЛ. С.KorostovtsevaL. S.

Коростовцева Людмила Сергеевна — кандидат медицинских наук, старший научный сотрудник группы по сомнологии научно-исследовательского отдела артериальной гипертензии Института сердца и сосудов, доцент кафедры кардиологии Института медицинского образования

ул. Аккуратова, д. 2, Санкт-Петербург,197341

Lyudmila S. Korostovtseva, MD, PhD, Senior Researcher, Somnology Group, Research Department for Hypertension, Associate Professor, Faculty Department of Cardiology

2 Akkuratov street, St Petersburg, 197341

korostovtseva_ls@almazovcentre.ruhttps://orcid.org/0000-0002-3170-0451СвиряевЮ. В.SviryaevYu. V.

Свиряев Юрий Владимирович — доктор медицинских наук, руководитель группы по сомнологии научно-исследовательского отдела артериальной гипертензии Института сердца и сосудов

ул. Аккуратова, д. 2, Санкт-Петербург,197341

Yurii V. Sviryaev, MD, PhD, DSc, Head, Somnology Group, Research Department for Hypertension

2 Akkuratov street, St Petersburg, 197341

sviryaev_yuv@almazovcentre.ruhttps://orcid.org/0000-0003-1409-7686ГавриловЮ. В.GavrilovYu. V.

Гаврилов Юрий Владимирович — кандидат медицинских наук, старший научный сотрудник отдела общей патологии и патологической физиологии

Санкт-Петербург

Yuri V. Gavrilov, MD, PhD, Senior Researcher, Department of General Pathology and Pathological Physiology

St. Petersburg

yury-doctor@mail.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени B. A. Алмaзoвa» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian FederationФедеральное государственное бюджетное научное учреждение «Институт экспериментальной медицины»РоссияInstitute of Experimental MedicineRussian Federation202125112021275488498Copyright © Терновых И.К., Алексеева Т.М., Коростовцева Л.С., Свиряев Ю.В., Гаврилов Ю.В., 20222022Терновых И.К., Алексеева Т.М., Коростовцева Л.С., Свиряев Ю.В., Гаврилов Ю.В.Ternovykh I.K., Alekseeva T.M., Korostovtseva L.S., Sviryaev Y.V., Gavrilov Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2125

В ряде исследований продемонстрирована высокая частота нарушений сна у пациентов с инсультом. В настоящем обзоре обсуждаются варианты расстройств бодрствования, наблюдаемые при ишемическом инсульте, с учетом актуальной терминологии, а также методы их диагностики. Предметом дискуссий остается происхождение постинсультной гиперсомноленции, отсутствует однозначное мнение о патофизиологии этого синдрома в раннем постинсультном периоде. Несмотря на то, что в качестве звеньев патогенеза гиперсомноленции, вызванной ишемическим инсультом, предлагаются механизмы орексин-лигандной недостаточности, дегенерации орексиновых нейронов, а также нарушения связей гистаминергической и орексинергической систем, конкретных и четких представлений о ее генезе до сих пор не сформировано. В статье рассмотрены вопросы патофизиологии гиперсомнии и избыточной дневной сонливости у пациентов с ишемическим инсультом, продемонстрированы различные точки зрения о взаимосвязи этих патологических феноменов с инсультом. На основании данных литературы рассмотрена гипотеза о компенсаторном характере гиперсомнии и избыточной дневной сонливости при остром ишемическом инсульте и их возможном нейропротективном воздействии на головной мозг у пациентов с инсультом.

A number of studies have demonstrated a high incidence of sleep disturbances in patients with stroke. The paper reviews the variants of wakefulness disorders observed in ischemic stroke, taking into account the current terminology, as well as methods for their diagnosis. Currently, the origin of post-stroke hypersomnolence and its pathophysiology remain debatable. Various mechanisms including orexin ligand deficiency, degeneration of orexin neurons, as well as disruption of the links between the histaminergic and orexinergic systems are considered as links in the pathogenesis of hypersomnolence caused by ischemic stroke. The paper discusses the pathophysiology of hypersomnia and excessive daytime sleepiness in patients with ischemic stroke, demonstrates various points of view on the relationship of these pathological phenomena with ischemic stroke. A hypothesis on the compensatory nature of hypersomnia and excessive daytime sleepiness in acute ischemic stroke and their possible neuroprotective effect on the brain in patients with stroke is presented.

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The authors declare that there are no conflicts of interest present.