0904 Exaggerated hypoxia burden of sleep apnea in patients with hyperacute lateral medullary infarction

Abstract

Abstract Introduction Acute lateral medullary infarction (LMI) can sometimes appear with respiratory failure in the acute stage. Polysomnographic investigations have shown a specific association between LMI and sleep apnea syndrome. The aim of our study was to investigate this association in hyperacute stage of LMI. Methods We investigated 8 patients who underwent polysomnography (PSG) for sleep apnea during hyperacute stage of LMI and compared the data to 8 healthy control subjects matched according to age, sex, body-mass index (BMI), and apnea-hypopnea index (AHI). The PSG was performed within an average of 1.5 days after the onset of neurological symptoms. PSG recordings in the hyperacute phase of LMI were analyzed. Results Six patients were males (75%) and two were females (25%). The average age of the patients was 51.9 ± 14.5 years and the average BMI was 27.2 ± 3.5. According to the AHI results of patients with LMI in the hyperacute phase, there were 2 (25%) cases of mild obstructive sleep apnea (OSA), 2 (25%) cased of moderate OSA, and 4 (50%) cases of severe OSA. The central sleep apnea index was higher in the patient group (4.3 ± 5.4/hr) than the control group 0.6 ± 0.4/hr) and was statistically significant (p=0.035). On the other hand, sleep parameters (obstructive sleep apnea index, respiratory arousal index, mean saturation) related to obstructive sleep apnea were poor in the control group. Conclusion Our study showed that sleep apnea syndrome, particularly CSA, is common in the hyperacute phase of LMI compared to control group. Early recognition of this problem and appropriate intervention may minimize the adverse effects on the respiratory system and improve the prognosis. Further and follow-up studies are needed to clarify the clinical significance and appropriate treatment options in these patients. Support (if any)