Sleep-disordered breathing in patients with acute cerebral stroke

Abstract

The aim of the study was to investigate prevalence and types of sleep-disordered breathing (SDB) in patients with acute stroke. Methods. We prospectively enrolled 56 patients with acute stroke and 28 age- and gender-matched controls. The assessment included physical examination, brain computer tomography or magnetic resonance imaging or both, and full polysomnography. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) and outcomes ere assessed by the modified Rankin scale (mRS). Results. SDB was more prevalent in stroke patients than in control subjects (67.9% vs 10.7%, respectively; p = 0.001). Median apnea-hypopnea index (AHI) was higher in stroke patients compared to the control group (p = 0.001). SDB prevalence did not differ significantly between patients with ischemic or hemorrhagic stroke (p = 0.487). Compared to stroke patients without SDB, stroke patient with SDB were older (p = 0.031), more often were male (p = 0.04), more often had chronic heart failure (p = 0.016) and had higher mRS score 1 year after stroke (p = 0.033). No correlation was found between the prevalence of SDB and lesion location. SDB was predominantly obstructive in 65.8% and predominantly central in 34.2% of patients. Patients with central sleep apnea were older (p = 0.005), had lower BMI (p = 0.014) and more often suffered from atrial fibrillation (p = 0.005) and chronic heart failure (p < 0.001). Conclusion. SDB is highly prevalent in patients with acute stroke. Patients with SDB have worse functional outcome one year after stroke.