Risk factors for sleep apnea and results of respiratory polygraphy in patients with acute ischemic stroke
Main Article Content
Abstract
This study investigated the prevalence and risk factors of sleep apnea (SA) in patients with acute ischemic stroke. Among 99 patients assessed using respiratory polygraphy within 7 days of stroke onset, 66.7% had sleep apnea, mostly of the obstructive type. Severe SA was found in 25.3% of cases. Compared to non-apneic patients, those with SA had higher BMI, diabetes, higher Epworth Sleepiness Scale (ESS) and STOP-BANG scores, and a greater likelihood of lacunar stroke. Interestingly, although BMI was higher among patients with SA, it did not remain a significant factor in multivariate analysis. Instead, ESS score (OR = 1.14), early neurological deterioration (OR = 6.81), and diabetes mellitus (OR = 6.53) emerged as independent predictors. The study concludes that sleep apnea is common in acute ischemic stroke and emphasizes the need for objective sleep assessments, as traditional anatomical markers are not reliable indicators in this population.
Article Details
Keywords
sleep apnea, acute ischemic stroke, Cardiorespiratory polygraphy
References
2. Hasan F, Gordon C, Wu D, et al. Dynamic Prevalence of Sleep Disorders Following Stroke or Transient Ischemic Attack: Systematic Review and Meta-Analysis. Stroke. 2021;52(2):655-663. doi:10.1161/STROKEAHA.120.029847
3. Sahlin C, Sandberg O, Gustafson Y, et al. Obstructive Sleep Apnea Is a Risk Factor for Death in Patients With Stroke: A 10-Year Follow-up. Arch Intern Med. 2008;168(3):297. doi:10.1001/archinternmed.2007.70
4. Bravata DM, Concato J, Fried T, et al. Continuous Positive Airway Pressure: Evaluation of a Novel Therapy for Patients with Acute Ischemic Stroke. Sleep. 2011;34(9):1271-1277. doi:10.5665/SLEEP.1254
5. Boulos MI, Kamra M, Colelli DR, et al. SLEAP SMART (Sleep Apnea Screening Using Mobile Ambulatory Recorders After TIA/Stroke): A Randomized Controlled Trial. Stroke. 2022;53(3):710-718. doi:10.1161/STROKEAHA.120.033753
6. Chen H, Lowe AA, Bai Y, et al. Evaluation of a portable recording device (ApneaLinkTM) for case selection of obstructive sleep apnea. Sleep Breath. 2009;13(3):213-219. doi:10.1007/s11325-008-0232-4
7. Birkbak J, Clark AJ, Rod NH. The Effect of Sleep Disordered Breathing on the Outcome of Stroke and Transient Ischemic Attack: A Systematic Review. J Clin Sleep Med. 2014;10(01):103-108. doi:10.5664/jcsm.3376
8. Iranzo A, Santamaría J, Berenguer J, et al. Prevalence and clinical importance of sleep apnea in the first night after cerebral infarction. Neurology. 2002;58(6):911-916. doi:10.1212/WNL.58.6.911
9. Yoon CW, Park HK, Bae E kee, et al. Sleep Apnea and Early Neurological Deterioration in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis. 2020;29(2):104510. doi:10.1016/j.jstrokecerebrovasdis.2019.104510
10. Tenda ED, Henrina J, Cha JH, et al. Obstructive sleep apnea: Overlooked comorbidity in patients with diabetes. World J Diabetes. 2024;15(7):1448-1460. doi:10.4239/wjd.v15.i7.1448
11. Walker NA, Sunderram J, Zhang P, et al. Clinical utility of the Epworth sleepiness scale. Sleep Breath. 2020;24(4):1759-1765. doi:10.1007/s11325-020-02015-2
12. Anothaisintawee T, Sansanayudh N, Thamakaison S, et al. Neck Circumference as an Anthropometric Indicator of Central Obesity in Patients with Prediabetes: A Cross-Sectional Study. BioMed Res Int. 2019;2019:1-8. doi:10.1155/2019/4808541