Abstract 140: Sleep-Disordered Breathing Shortly After Stroke Does Not Predict Post-Stroke Fatigue at 3-months

Abstract

Background: Post-stroke fatigue (PSF) is a common and often disabling symptom, the causes of which are poorly understood. Sleep-disordered breathing (SDB) is highly prevalent among stroke survivors, and can cause fatigue. We examined whether SDB measured shortly after stroke predicted PSF at 3-months, and thus whether SDB might represent an intervention target for the treatment/prevention of PSF. Methods: Ischemic stroke (IS) patients within the Brain Attack Surveillance in Corpus Christi (BASIC) project were identified through active and passive surveillance, and were offered SDB screening with a well-validated cardiopulmonary sleep apnea testing device. The primary exposure was the respiratory event index (REI; sum of apneas plus hypopneas per hour of recording), measured shortly after stroke. The primary outcome was PSF, measured 3-months post-stroke, using the SF-36 vitality scale. Linear regression was used to evaluate the association between baseline REI and 3-month PSF, adjusting for clinical and sociodemographic factors listed in the Table, which were obtained from chart review and interviews. Results: A total of 355 IS participants completed baseline SDB screening and 3-month PSF assessments from May 2016 to December 2019. Participants were 44% female, 60% Mexican American (MA), and had a median NIHSS of 2 (IQR: 1-5). Multivariable regression model results are presented in the Table. No association between baseline REI and 3-month PSF was observed in unadjusted (β=0.95, 95% CI=-1.16, 3.05) or fully adjusted models (β=0.66, 95% CI=-1.40, 2.73). In the fully adjusted model, female sex and depression were associated with greater fatigue, while older age and MA ethnicity were associated with less fatigue. Conclusions: SDB in the immediate post-stroke period, at least in this predominantly MA sample, does not predict PSF at 3-months. Though identification and treatment of post-stroke SDB may be important, these efforts are unlikely to impact PSF.