Hypersomnia and excessive daytime sleepiness in ischemic stroke

Abstract

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.