Abstract 27: Sleep Apnea and Ischemic Stroke Subtype: The BASIC Sleep Project
Background: Little is known about the prevalence of sleep apnea (SA) across ischemic stroke subtypes. Given the important implications for SA screening, we tested the association between SA and ischemic stroke subtype in a population-based study.
Methods: Within the Brain Attack Surveillance in Corpus Christi Project, ischemic stroke patients were offered SA screening with the ApneaLink PlusTM device (n=355). A board-certified neurologist assigned TOAST subtype (with an additional category for nonlacunar infarctions of unknown etiology) using hospital records (diagnostic tests, imaging reports, discharge summaries). Unadjusted and adjusted (demographics, BMI, NIHSS, diabetes, history of stroke/TIA) logistic and linear regression models were used to test the association between subtype and SA or apnea-hypopnea index (AHI).
Results: Median age was 65 and 55% were male; 59% were Mexican American. Median time from stroke onset to SA screen was 13 days (IQR: 6, 21). Overall, 215 (61%) had SA (AHI ≥10). Median AHI was 13 (IQR: 6, 27). Prevalence of SA by subtype was: cardioembolism, n=42/64, 66%; large artery atherosclerosis, n=13/23, 57%; small vessel occlusion, n=17/25, 68%; other determined, n=1/2, 50%; undetermined etiology, n=65/113, 58%; and nonlacunar stroke of unknown etiology, n=80/128, 63%. Ischemic stroke subtype (other determined excluded due to small numbers) was not associated with SA in unadjusted (p=0.72) or adjusted models (p=0.91) models. Ischemic stroke subtype was not associated with AHI in unadjusted (p = 0.41) or adjusted models (p=0.62).
Conclusion: In this population-based stroke surveillance study performed in a bi-ethnic community, ischemic stroke subtype was not associated with the presence or severity of SA. Sleep apnea is likely to be present after ischemic stroke, and the subtype should not influence decisions about SA screening during inpatient hospitalizations.
Author Disclosures: D.L. Brown: Research Grant; Significant; NIH grants R01 NS062675, R01 HL098065, and R01 NS070941. A. Mowla: None. M. McDermott: None. L.B. Morgenstern: Research Grant; Modest; St. Jude Medical. R.D. Chervin: Research Grant; Significant; R01 NS070941, R01 HL098065, R01 HL105999, and R43 HL117421. Consultant/Advisory Board; Modest; Educational gifts to UM from Philips Respironics and Fisher Paykel; advisory boards for the non-profit Sweet Dreamzzz and the NHLBI; consulted for Proctor & Gamble and Zansors;. Other; Modest; serves as a section editor for UpToDate. G. Hegeman: Research Grant; Significant; R01 HL098065. M.A. Smith: Research Grant; Significant; R01 NS38916, R01 NS062675, R01 HL098065. N.M. Garcia: Research Grant; Significant; R01 NS38916, R01 NS062675, R01 HL098065. L.D. Lisabeth: Research Grant; Significant; R01 NS38916, R01 NS062675, R01 HL098065, and R01 NS070941.
- © 2014 by American Heart Association, Inc.