Obstructive sleep apnea confers lower mortality risk in acute ischemic stroke patients treated with endovascular thrombectomy: National inpatient sample analysis 2010–2018

2021 ◽  
Vol 429 ◽  
pp. 117665
Author(s):  
Justin Lapow ◽  
Alis Dicpinigaitis ◽  
Rajkumar Pammal ◽  
Griffin Coghill ◽  
Osher Rechester ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Mortality Risk ◽  
National Inpatient Sample ◽  
Sample Analysis ◽  
Stroke Patients ◽  
Endovascular Thrombectomy ◽  
Obstructive Sleep ◽  
Lower Mortality Risk

Abstract TP221: Using Berlin Questionnaire and Epworth Sleepiness Scale to Identify Stroke Patients at Risk for the Sleep Apnea Syndrome

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Millene Camilo ◽  
Alan Eckeli ◽  
Heidi Sander ◽  
Regina Fernandes ◽  
Joao Leite ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Epworth Sleepiness Scale ◽  
Berlin Questionnaire ◽  
Stroke Patients ◽  
Obstructive Sleep

Background: Sleep-disordered breathing (SDB) is frequent in the acute phase of stroke. Obstructive sleep apnea (OSA) has been found in 62% of stroke patients. The impact of OSA is significant after ischemic stroke, including early neurological deterioration, poor functional outcome and increased long-term mortality. However, performing polysomnography (PSG) for all patients with acute stroke for diagnose OSA is still impracticable. Therefore clinical tools to select patients at higher risk for OSA would be essential. The aim of this study was to determine the validity of the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESS) to identify stroke patients in whom the PSG would be indicated. Methods: Subjects with ischemic stroke were stratified into high and low risk groups for SDB using a BQ. The ESS ≥ 10 was used to define excessive daytime sleepiness. The BQ and ESS were administered to the relatives of stroke patients at hospital admission. All patients were submitted to a full overnight PSG at the first night after symptoms onset. OSA severity was measured by the apnea-hypopnea index (AHI). Results: We prospectively studied 40 ischemic stroke patients. The mean age was 62 ± 12.1 years and the obstructive sleep apnea (AHI ≥ 15) was present in 67.5%. On stratifying risk of OSA in these patients based on the QB, 77.5% belonged to the high-risk and 50% to the ESS ≥ 10. The sensitivity of QB was 85%, the specificity 35%, the positive predictive value 74% and the negative predictive value 55%. For ESS was respectively 63%, 85%, 89% and 52%. The diagnostic value of the BQ and ESS in combination to predict OSA had a sensitivity of 58%, a specificity of 89%, a positive predictive value of 95% and a negative predictive value of 38%. Conclusions: The QB even applied to the bed-partners of stroke patients is a useful screening tool for OSA.

scholarly journals Obstructive sleep apnea in ischemic stroke patients

Clinics ◽  
2008 ◽  
Vol 63 (5) ◽  
Author(s):  
Aliye Tosun ◽  
Ouz Köktürk ◽  
Gülçin Kaymak Karata ◽  
Tansu Ulukavak Çiftçi ◽  
Vesile Sepici
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Stroke Patients ◽  
Obstructive Sleep

Positional therapy in ischemic stroke patients with obstructive sleep apnea

2011 ◽  
Vol 12 (3) ◽  
pp. 262-266 ◽  
Author(s):  
Anna Svatikova ◽  
Ronald D. Chervin ◽  
Jeffrey J. Wing ◽  
Brisa N. Sanchez ◽  
Erin M. Migda ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Positional Therapy ◽  
Stroke Patients ◽  
Obstructive Sleep

scholarly journals Acute stroke and TIA patients have specific polygraphic features of obstructive sleep apnea

2020 ◽  
Vol 24 (4) ◽  
pp. 1495-1505 ◽  
Author(s):  
Akseli Leino ◽  
Susanna Westeren-Punnonen ◽  
Juha Töyräs ◽  
Sami Myllymaa ◽  
Timo Leppänen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Transient Ischemic Attack ◽  
Sleep Disordered Breathing ◽  
Apnea Hypopnea Index ◽  
Stroke Patients ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Ischemic Attack

Abstract Purpose Obstructive sleep apnea (OSA) is associated with increased risk for stroke, which is known to further impair respiratory functions. However, it is unknown whether the type and severity of respiratory events are linked to stroke or transient ischemic attack (TIA). Thus, we investigate whether the characteristics of individual respiratory events differ between patients experiencing TIA or acute ischemic stroke and matched patients with clinically suspected sleep-disordered breathing. Methods Polygraphic data of 77 in-patients with acute ischemic stroke (n = 49) or TIA (n = 28) were compared to age, gender, and BMI-matched patients with suspected sleep-disordered breathing and no cerebrovascular disease. Along with conventional diagnostic parameters (e.g., apnea-hypopnea index), durations and severities of individual apneas, hypopneas and desaturations were compared between the groups separately for ischemic stroke and TIA patients. Results Stroke and TIA patients had significantly shorter apneas and hypopneas (p < 0.001) compared to matched reference patients. Furthermore, stroke patients had more central apnea events (p = 0.007) and a trend for higher apnea/hypopnea number ratios (p = 0.091). The prevalence of OSA (apnea-hypopnea index ≥ 5) was 90% in acute stroke patients and 79% in transient ischemic attack patients. Conclusion Stroke patients had different characteristics of respiratory events, i.e., their polygraphic phenotype of OSA differs compared to matched reference patients. The observed differences in polygraphic features might indicate that stroke and TIA patients suffer from OSA phenotype recently associated with increased cardiovascular mortality. Therefore, optimal diagnostics and treatment require routine OSA screening in patients with acute cerebrovascular disease, even without previous suspicion of OSA.

Association of obstructive sleep apnea and stenotic artery disease in ischemic stroke patients

2003 ◽  
Vol 169 (2) ◽  
pp. 301-307 ◽  
Author(s):  
Andreas Nachtmann ◽  
Andreas Stang ◽  
You-Ming Wang ◽  
Elke Wondzinski ◽  
Alfred F. Thilmann
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Stroke Patients ◽  
Obstructive Sleep ◽  
Artery Disease

Abstract W P224: SOS Score: an Optimized Score to Screen Acute Stroke Patients for Obstructive Sleep Apnea

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Millene R Camilo ◽  
Heidi H Sander ◽  
Alan L Eckeli ◽  
Regina M Fernandes ◽  
Taiza E Santos-Pontelli ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Acute Stroke ◽  
Predictive Value ◽  
Screening Tools ◽  
Berlin Questionnaire ◽  
Stroke Patients ◽  
Obstructive Sleep ◽  
The Mean

Background: Obstructive sleep apnea (OSA) is frequent in acute stroke patients and is associated with increased mortality and poor functional outcome. Polysomnography (PSG) is the gold standard diagnostic method for OSA, but it is impracticable as a routine for all acute stroke patients. We evaluated how OSA screening tools such as the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESS) would perform when administered to relatives of stroke patients in the acute setting, and compared these individual tools against a combined screening score (SOS score). Methods: Ischemic stroke patients were submitted to a full PSG at the first night after symptoms onset. OSA severity was measured by apnea-hypopnea index (AHI). BQ and ESS were administered to relatives of stroke patients before the PSG. We combined elements of the BQ and ESS to create a new screening tool for OSA named Sleep Obstructive apnea score optimized for Stroke (SOS score). Results: Thirty-nine consecutives ischemic stroke patients were enrolled in our study. The mean age was 62.3 ±12.2 years. Age was significantly different between those with and without OSA (p=0.02). The mean body mass index and neck circumference were 26.7 ± 4.7 and 38.9 ± 4.0cm, respectively. OSA (AHI ≥ 10) was present in 76.9%. The area under the curve for SOS score (AUC:0.812; p=0.005) was superior to BQ (AUC:0.567; p=0.549) and also to ESS (AUC:0.646; p=0.119 vs. AUC:0.686; p=0.048) for severe OSA (IAH ≥ 30). The threshold of SOS ≤ 10 (present in 20.5% of patients) showed high sensitivity (90%) and negative predictive value (96.2%) for OSA; SOS ≥20 (17.9% of patients) showed high specificity (100%) and positive predictive value (92.5%) for severe OSA. Using SOS as a screening approach would decrease by around 40% the demand for PSG during the acute stroke setting. Conclusions: The SOS score when administered to relatives of stroke patients appears to be an appropriate tool to screen acute stroke patients for OSA, while decreasing the need for a formal sleep study during the acute stroke setting. The new derived SOS score is superior to BQ and ESS for identifying patients with OSA and Severe OSA during the acute phase of stroke.

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