Obstructive Sleep Apnea is Related to Impaired Cognitive and Functional Status after Stroke.

Justine A Aaronson,Joost G Van Den Aardweg,Wytske A Kylstra,Tijs Van Bezeij,Winni F Hofman,Ben Schmand,Coen A.M Van Bennekom,Erny Groet

doi:10.5665/sleep.4984

Justine A Aaronson, Joost G Van Den Aardweg + Show 6 more

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https://doi.org/10.5665/sleep.4984

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Abstract

Obstructive sleep apnea (OSA) is a common sleep disorder in stroke patients and is associated with prolonged hospitalization, decreased functional outcome, and recurrent stroke. Research on the effect of OSA on cognitive functioning following stroke is scarce. The primary objective of this study was to compare stroke patients with and without OSA on cognitive and functional status upon admission to inpatient rehabilitation. Case-control study. 147 stroke patients admitted to a neurorehabilitation unit. N/A. All patients underwent sleep examination for diagnosis of OSA. We assessed cognitive status by neuropsychological examination and functional status by two neurological scales and a measure of functional independence. We included 80 stroke patients with OSA and 67 stroke patients without OSA. OSA patients were older and had a higher body mass index than patients without OSA. OSA patients performed worse on tests of attention, executive functioning, visuoperception, psychomotor ability, and intelligence than those without OSA. No differences were found for vigilance, memory, and language. OSA patients had a worse neurological status, lower functional independence scores, and a longer period of hospitalization in the neurorehabilitation unit than the patients without OSA. OSA status was not associated with stroke type or classification. Obstructive sleep apnea (OSA) is associated with a lower cognitive and functional status in patients admitted for stroke rehabilitation. This underlines the importance of OSA as a probable prognostic factor, and calls for well-designed randomized controlled trials to study its treatability.

Highlights

Stroke is one of the leading causes of death and serious long-term disability worldwide, and is a source of increased health care costs.[1]
Participants Stroke patients admitted to the neurorehabilitation unit of Heliomare Rehabilitation Center between September 2011 and August 2014 were invited to participate if they met the following inclusion criteria: (1) stroke confirmed by a neurologist, DownloadedSLfEroEmPh, tVtopls.:3//8a,cNadoe.m9i,c.2o0u1p5.com/sleep/article-abstract/38/9/1431/241800134/3Ob1structive-SlOebeps-trAupcnteivae-iSsl-eReeplaAtpend-etaoa-InmdpSaitrroekde Outcome—Aaronson et al
We found that Obstructive sleep apnea (OSA) patients had a significantly lower functional status than non-OSA patients (Table 3)

Summary

Introduction

Stroke is one of the leading causes of death and serious long-term disability worldwide, and is a source of increased health care costs.[1] In recent years efforts have been made to improve stroke prevention by early recognition and treatment of well-known modifiable risk factors such as hypertension, diabetes mellitus, and obesity.[1] The identification of new, potentially reversible risk factors has received increased attention. In this context, obstructive sleep apnea (OSA) has been suggested.

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