Abstract TP347: Obstructive Sleep Apnea Frequency in Intracerebral Hemorrhage

Abstract

Introduction: Obstructive sleep apnea (OSA) is a treatable condition and well-established risk factor for ischemic stroke, but the prevalence in ICH is unknown. We aim to characterize the frequency of OSA in spontaneous intracerebral hemorrhage (ICH). Methods: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a prospective observational study evaluating risk factors for ICH among whites, blacks, and Hispanics. OSA status was determined using two different strategies: (1) the Berlin Questionnaire, a validated screening tool to identify those with a high likelihood of OSA where “high risk” is defined as > 1 point in at least 2 of 3 categories assessing snoring, fatigue, and hypertension, and (2) self-reported history of diagnosed sleep apnea. Results: We evaluated 3000 ICH cases. Within this group, 2896 (96.5%) completed the Berlin questionnaire, with 2064 (71%) patients being high risk for OSA. Compared to patients with low risk of OSA, those at high risk were more likely to be male (61% versus 53%, p<0.001) with hypertension (93% versus 65%, p<0.001), diabetes (32% versus 20%, p<0.001), hyperlipidemia (49% versus 38%, p<0.001), and higher BMI (29.8 +/- 8.1 versus 26.8 +/- 6.5, p<0.001), and less likely to have lobar ICH location (29% versus 35%, p<0.001). Self-reported history of prior sleep apnea diagnosis was present in only 175 (9.5%) of ICH cases. Conclusions: OSA is highly prevalent and underdiagnosed in our cohort of ICH patients. Given the effective treatments available for OSA, which have been shown to improve morbidity and mortality in patients with ischemic stroke, further studies are needed to assess the role of OSA as both a determinant of both risk and outcome in ICH.