الفهرس 
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Abstract
In the present study, the aim was to compare the polysomnographic profile between patients with wake-up thrombotic cerebrovascular stroke and patients with daytime thrombotic cerebrovascular stroke. To achieve this aim, the following groups were studied:
• group I:
Twenty patients with ischemic non-embolic cerebrovascular stroke with the onset of stroke symptoms during wakefulness daytime period.
• group II:
Twenty patients with ischemic non-embolic cerebrovascular stroke with the onset of stroke symptoms during the sleep period.
Inclusion criteria:
1. The patient was recently diagnosed with cerebrovascular ischemic stroke within one week.
2. Patients above the age of 45 years
3. Patients with non-embolic types of ischemic cerebrovascular stroke
4. National Institutes of Health Stroke Scale (NIHSS) score not exceeding 20.
5. Glasgow coma scale (GCS) not less than 11.
Exclusion criteria:
1. Patients with co-morbid psychiatric illness affecting sleep; like depression or anxiety.
2. Patients on medications that affect sleep e.g., hypnotics or stimulants.
3. Patients with pre-existing documented sleep disorders.
4. Patients with embolic ischemic stroke or hemorrhagic strokes.
5. Patients with other structural brain lesions.
Methods:
1. Ethical approval and written informed consent from all the subjects.
2. Complete history taking from all patients including; age, sex, neurological complain, drug history, surgical history, and family history.
3. Pittsburgh Sleep Quality Index (PSQI) questionnaire.
4. Complete neurological examination for each patient in both groups.
5. Blood pressure measurement and assessment presence BP dipping and BP surge.
6. Lab tests including complete blood count, liver enzymes, renal function tests, triglyceride, cholesterol, and fasting blood glucose.
7. Brain imaging (CT scan or MRI in some cases).
8. Overnight polysomnography (PSG): using the data acquisition system, 32 channels Cadwell (Version 2.1) using the standard polysomnogram recording with the following parameters monitored: 4 channel electroencephalography (EEG), two electrooculograms (EOG), submental electromyogram (EMG), nasal oral airflow, electrocardiography (ECG), strain gauges around the thorax and abdomen, one channel for oxygen saturation and two leads for leg electromyogram.
The sleep architecture of the WUS patients was compared to daytime stroke patients.
from the study we came out with the following results:
I- As regards BP assessment:
1. The percentage of non-dippers among wake-up stroke patients was significantly higher than those among daytime stroke patients.
2. Blood pressure surge was significantly higher among wake-up stroke patients than daytime stroke patients.
II- As regards the sleep architecture:
1. WUS patients had a significantly shorter REM stage and longer stage 2 than daytime stroke patients.
2. WUS patients had a longer duration of early morning REM than daytime stroke patients.
3. The AHI during REM sleep was significantly higher in WUS patients than in daytime stroke patients.
4. The mean SO2 during REM was significantly lower in WUS patients in comparison to daytime stroke patients.
5. The PLM index and PLM-related arousals were significantly higher among patients with daytime stroke in comparison to WUS patients.