P9-13 Prevalence of obstructive sleep apneas in acute stroke patients

Abstract

Objective: Aim of this study is to investigate the prevalence and clinical correlates of obstructive sleep apnea (OSA) in acute stroke patients. Background: Recent literature demonstrates that OSA is an independent risk factor for acute stroke, yet stroke may also lead to OSA. Moreover, several studies suggest that OSA in acute stroke is associated with a worse clinical outcome by compromising hemodynamics and oxygenation in a phase of critically affected but viable brain tissue (penumbra). Continuous Positive Airways Pressure (CPAP) therapy in acute stroke patients has been proposed as a means of reducing secondary damage to the penumbra, yet the procedure seems hampered by feasibility issues in the acute stroke setting. This study aimed to (1) evaluate the prevalence of OSA in the setting of acute stroke, and (2) investigate which clinical characteristics distinguish acute stroke patients with from those without OSA. Methods: A prospective study was carried out in consecutive patients admitted to the stroke unit with an acute ischemic stroke. In all patients, clinical characteristics and a sleep history was performed and a polygraphic examination was conducted with an Embletta polygraph (Embla, USA) within 48 hours of stroke onset. Results: 20 patients consented to study inclusion (mean age 68 years, mean BMI 29). Stroke severity was mild to moderate (mean National Institute of Health Scale Score 7). OSA, defined as an apnea hypopnea index (AHI) 5, was seen in 55% andAHI 20 in 15% of the stroke patients. There were no clinical stroke characteristics that distinguished patients with from patients without OSA. Conclusions: OSA in acute ischemic stroke patients is a common phenomenon. In order to protect the penumbra, OSA screening and treatment might be considered as part of standard stroke unit care.