Abstract P696: Organic Sleep Disorders Are Linked With Stroke- A Nationwide Population Study

Abstract

Objective: Primary aim of this study is to identify prevalence of organic sleep disorders (OSDs) [REM sleep behaviour disorder (REMSBD), hypersomnia, parasomonia, insomnia, circadian rhythm] and compare prevalence of stroke [acute ischemic stroke (AIS), transient ischemic attack (TIA), intracerebral hemorrhage (ICeH), subarachnoid hemorrhage (SAH)] amongst OSDs. Secondary aim of the study is to evaluate the association between OSDs and stroke subtypes. Methods: A retrospective study was performed using National Inpatient Sample [2016-2017] for adult hospitalizations. We extracted a cohort of diagnoses of OSDs amongst which diagnoses of stroke were identified using ICD 10 code. Weighted analysis using chi-square test and mix-effects multivariable survey logistic regression was performed to evaluate the prevalence and odds of stroke amongst OSDs. Results: Out of 58,259,589 US hospitalizations, 2715 (0.00005%), 4120 (0.01%), 3420 (0.01%), 1,301,209 (2.23%) and 24870 (0.04%) had REMSBD, parasomnia, circadian rhythm, insomnia, and hypersomnia, respectively. Prevalence of AIS was higher in REMSBD [3.1 vs 2.1% p<.0004], hypersomnia [2.7 vs 2.1% p<.0001], parasomnia [2.6 vs 2.1% p=.0714], and circadian rhythm [2.8 vs 2.1% p=.0102]. Prevalence of TIA was higher in REMSBD [1.3 vs 0.6% p<.0001], parasomnia [1.3 vs 0.6% p<.0001] and hypersomnia [0.7 vs 0.5% p=.0188]. Prevalence of ICeH was higher in hypersomnia [0.5 vs 0.4% p=.0043], parasomnia [0.5 vs 0.4% p=.3239], and circadian rhythm [1.3 vs 0.4% p=.0188]. Prevalence of SAH was higher in circadian rhythm [0.6 vs 0.1% p<.0001]. In analysis, patients with parasomnia had higher odds of TIA [aOR 2.8; 95%CI 1.02-7.5] and a weak association with ICeH [1.9 (0.5-7.9)]. Circadian rhythm OSD had 214% [3.1 (1.6-6.1)] and 310% [4.1 (1.5-11.0)] higher risk of ICeH and SAH, respectively and a weak association with AIS [1.3 (0.8-2.1)]. Hypersomnia had a weak association with AIS [1.2 (1.0-1.4)], TIA [1.1 (0.8-1.6)] and ICeH [1.4 (0.9-2.0)]. REMSBD had a weak association with AIS [3.6 (0.8-15.4)]. Conclusion: Our study shows organic sleep disorders (OSDs) are associated with strokes. Even Though the extent of association varies in each OSDs, early identification and prompt management of OSDs may mitigate the risk of stroke.