Abstract
In acute stroke, OSA has been found to impair rehabilitation and increase mortality but the effect of central apnea is more unclear. The aim of the present study was to evaluate the feasibility of using limited ambulatory recording system (sleep mattress to evaluate nocturnal breathing and EOG-electrodes for sleep staging) in sleep disordered breathing (SDB) diagnostics in mild acute cerebral ischemia patients and to discover the prevalence of various SDB-patterns among these patients. 42 patients with mild ischemic stroke or transient ischemic attack were studied. OSA was found in 22 patients (52.4%). Central apnea was found in two patients (4.8%) and sustained partial obstruction in only one patient (2.4%). Sleep staging with EOG-electrodes only yielded a similar outcome as scoring with standard rules. OSA was found to be common even after mild stroke. Its early diagnosis and treatment would be favourable in order to improve recovery and reduce mortality. Our results suggest that OSA can be assessed by a limited recording setting with EOG-electrodes, sleep mattress, and pulse oximetry.
Highlights
Sleep disordered breathing (SDB) is common in cerebrovascular disease [1]
Obstructive sleep apnea (OSA) constitutes a risk factor for cerebrovascular events, and it is frequently seen in patients with both stroke and transient ischemic attack (TIA) [1, 2]
The initial eligibility criteria for the study were as follows: (a) TIA or mild ischemic stroke, the severity defined as National Institutes of Health Stroke Scale (NIHSS) score < 12, and (b) no previous Continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA)
Summary
Sleep disordered breathing (SDB) is common in cerebrovascular disease [1]. In particular, obstructive sleep apnea (OSA) constitutes a risk factor for cerebrovascular events, and it is frequently seen in patients with both stroke and transient ischemic attack (TIA) [1, 2]. Continuous positive airway pressure (CPAP) treatment for OSA in stroke patients has been found to decrease mortality, improve functional recovery, increase subjective well-being and mood, and inhibit recurrent strokes [6,7,8,9,10]. Even though routine screening of OSA in the stroke units is becoming more common, it is not usually performed in the stroke units in Finland. One reason for this might be that patients with both stroke and OSA do not present the typical clinical picture of sleep apnea; they are often neither obese nor sleepy [4, 12, 13]. Patients in stroke units may have many different monitoring devices, as well as nasal supplementary oxygen therapy, and performing nocturnal polygraphy with additional sensors is perhaps not favored
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