Sleep-disordered breathing in patients with acute cerebral stroke
https://doi.org/10.18093/0869-0189-2018-28-1-69-74
Abstract
The aim of the study was to investigate prevalence and types of sleep-disordered breathing (SDB) in patients with acute stroke. Methods. We prospectively enrolled 56 patients with acute stroke and 28 age- and gender-matched controls. The assessment included physical examination, brain computer tomography or magnetic resonance imaging or both, and full polysomnography. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) and outcomes ere assessed by the modified Rankin scale (mRS). Results. SDB was more prevalent in stroke patients than in control subjects (67.9% vs 10.7%, respectively; p = 0.001). Median apnea-hypopnea index (AHI) was higher in stroke patients compared to the control group (p = 0.001). SDB prevalence did not differ significantly between patients with ischemic or hemorrhagic stroke (p = 0.487). Compared to stroke patients without SDB, stroke patient with SDB were older (p = 0.031), more often were male (p = 0.04), more often had chronic heart failure (p = 0.016) and had higher mRS score 1 year after stroke (p = 0.033). No correlation was found between the prevalence of SDB and lesion location. SDB was predominantly obstructive in 65.8% and predominantly central in 34.2% of patients. Patients with central sleep apnea were older (p = 0.005), had lower BMI (p = 0.014) and more often suffered from atrial fibrillation (p = 0.005) and chronic heart failure (p < 0.001). Conclusion. SDB is highly prevalent in patients with acute stroke. Patients with SDB have worse functional outcome one year after stroke.
About the Author
A. D. Tazartukova
N.I.Pirogov Russian State National Research Medical University, Healthcare Ministry of Russia.
Russian Federation
Russian Federation
Aminat D. Tazartukova, postgraduate student, Department of Neurology, Neurosurgery and Clinical Genetics.
ul. Ostrovityanova 1, Moscow, 117997.
References
1. Johnson K.G., Johnson D.C. Frequency of sleep apnea in stroke and TIA patients: a metaanalysis. J. Clin. Sleep. Med. 2010; 6 (2): 131–137.
2. Kaneko Y., Hajek V.E., Zivanovic V. et al. Relationship of sleep apnea to functional capacity and length of hospitalization following stroke. Sleep. 2003; 26 (3): 293–297.
3. Siccoli M.M., Tettenborn B., Kollias S., Basetti C.L. Acute ischemic stroke and sleep apnea: Evolution of radiological parameters within 3 days after stroke onset. Sleep Med. 2006; 7 (Suppl. 2): S62. DOI: 10.1016/j.sleep.2006.07.151.
4. Good D.C., Henkle J.Q., Gelber D. et al. Sleep-disordered breathing and poor functional outcome after stroke. Stroke. 1996; 27 (2): 252–259.
5. Sahlin C., Sandberg O., Gustafson Y. et al. Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Arch. Intern. Med. 2008; 168 (3): 297–301. DOI: 10.1001/archinternmed.2007.70.
6. Berry R.B., Brooks R., Gamaldo C.E. et al. 2014. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.1. American Academy of Sleep Medicine, Darien, IL; 2014. Available at: https://aasm.org
7. Väyrynen K., Kortelainen K., Numminen H. et al. Screening sleep disordered breathing in stroke unit. Sleep Disord. 2014; 2014: 317615. DOI: 10.1155/2014/317615.
8. Stahl S.M., Yaggi H.K., Taylor S. et al. Infarct location and sleep apnea: evaluating the potential association in acute ischemic stroke. Sleep Med. 2015; 16 (10): 1198–1203. DOI: 10.1016/j.sleep.2015.07.003.
9. Brown D.L., Mowla A., McDermott M. et al. Ischemic stroke subtype and presence of sleep-disordered breathing: the BASIC sleep apnea study. J. Stroke Cerebrovasc. Dis. 2015; 24 (2): 388–393. DOI: 10.1016/j.jstrokecerebrovasdis.2014.09.007.
10. Camilo M.R., Fernandes R.M., Sander H.H. et al. Supine sleep and positional sleep apnea after acute ischemic stroke and intracerebral hemorrhage. Clinics. 2012; 67 (12): 1357–1360. DOI: 10.6061/clinics/2012(12)02.
11. Parra O., Arboix A., Bechich S. et al. Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack. Am. J. Respir. Crit. Care Med. 2000; 161 (2, Pt 1): 375–380. DOI: 10.1164/ajrccm.161.2.9903139.
12. Wang Y., Wang Y., Chen J. et al. Stroke patterns, topography and etiology in patients with obstructive sleep apnea-hypopnea syndrome. Int. J. Clin. Exp. Med. 2017; 10 (4): 7137–7143.
13. Ahn S.H., Kim J.H., Kim D.U. et al. Interaction between sleep-disordered breathing and acute ischemic stroke. J. Clin. Neurol. 2013; 9 (1): 9–13. DOI: 10.3988/jcn.2013.9.1.9.
14. Bassetti C., Aldrich M.S. Sleep apnea in acute cerebrovascular diseases: final report on 128 patients. Sleep. 1999; 22 (2): 217–223.
15. Arzt M., Young T., Peppard P.E. et al. Dissociation of obstructive sleep apnea from hypersomnolence and obesity in patients with stroke. Stroke. 2010; 41 (3): e129–134. DOI: 10.1161/STROKEAHA.109.566463.
16. Brown D.L., McDermott M., Mowla A. et al. Brainstem infarction and sleep-disordered breathing in the BASIC sleep apnea study. Sleep Med. 2014; 15 (8): 887–891. DOI: 10.1016/j.sleep.2014.04.003.
17. Fisse A.L., Kemmling A., Teuber A. et al. The association of lesion location and sleep related breathing disorder in patients with acute ischemic stroke. PLoS ONE. 2017; 12 (1): e0171243. DOI: 10.1371/journal.pone.0171243.
18. Terzoudi A., Vorvolakos T., Heliopoulos I. et al. Sleep architecture in stroke and relation to outcome. Eur. Neurol. 2009; 61 (1): 16–22. DOI: 10.1159/000165344.
19. Lyons O.W., Ryan C.M. Sleep apnea and stroke. Can. J. Cardiol. 2015; 31 (7): 918–927. DOI: 10.1016/j.cjca.2015.03.014.
20. King S., Cuellar N. Obstructive sleep apnea as an independent stroke risk factor: a review of the evidence, stroke prevention guidelines, and implications for neuroscience nursing practice. J. Neurosci. Nurs. 2016; 48 (3): 133–142. DOI: 10.1097/JNN.0000000000000196.
21. Sacchetti M.L., Di Mascio M.T., Marca G.D. et al. Sleep disordered breathing after stroke: clinical profile of patients with obstructive – as opposed to central sleep apnea. J. Sleep. Disorders Ther. 2013; 2: 113. DOI: 10.4172/2167-0277.1000113.
22. Aaronson J.A., van Bennekom C.A., Hofman W.F. et al. Obstructive sleep apnea is related to impaired cognitive and functional status after stroke. Sleep. 2015; 38 (9): 1431–1437. DOI: 10.5665/sleep.4984.
Review
For citations:
Tazartukova A.D. Sleep-disordered breathing in patients with acute cerebral stroke. PULMONOLOGIYA. 2018;28(1):69-74. (In Russ.) https://doi.org/10.18093/0869-0189-2018-28-1-69-74
Views:
2068
Email this article 