Abstract W P129: Association Between Acute Stroke Location and Sleep-Disordered Breathing
BACKGROUND: A high prevalence of sleep-disordered breathing (SDB) has been demonstrated among stroke patients. The literature about the relationship between SDB and stroke location is conflicting with some studies finding an association and others demonstrating no relationship. Among acute ischemic stroke patients, we sought to examine the relationship between stroke location and the prevalence of obstructive sleep apnea (OSA) (apnea hypopnea index [AHI] ≥ 5 events/hour) and sleep apnea severity (defined by AHI).
METHODS: Data were obtained from 236 patients participating in an ongoing randomized controlled trial (NCT01446913) that is evaluating the effectiveness of a strategy of diagnosing and treating SDB among patients with acute ischemic strokes and transient ischemic attacks. As part of this trial, all intervention patients receive polysomnography. Demographics, pre-stroke disability, comorbidities, National Institutes of Health Stroke Scale, clinical and laboratory parameters, and Epworth Sleepiness Scale are also recorded. Stroke location was classified by brain imaging (MRI or CT) reports as follows: lobe (frontal, parietal, temporal, insular, occipital), subcortical (thalamus, basal ganglia, internal capsule, corona radiata, corpus callosum), brainstem (midbrain, pons, medulla), cerebellum, and vascular territory. The association between acute stroke location and polysomnographic findings was evaluated using logistic regression for SDB presence and negative binomial regression for AHI.
RESULTS: Among 94 patients with complete polysomnography and stroke location data, 72 (77%) had OSA. In unadjusted models, no stroke location variable was associated with the prevalence of SDB or its severity. Similarly, in multivariable modeling accounting for baseline characteristics that were associated with SDB (e.g., neck circumference), stroke location was not associated with SDB presence.
CONCLUSIONS: These results confirm that SDB is present in the majority of stroke patients and suggest that stroke location cannot be used to identify a group with higher risk of SDB. Given this high overall prevalence, strong consideration should be given to providing polysomnography for all ischemic stroke patients.
Author Disclosures: S.M. Stahl: None. S. Taylor: None. S. Ofner: None. L. Qin: None. K. Yaggi: None. C. Ivan: None. D.M. Bravata: None.
- © 2014 by American Heart Association, Inc.