Sleep-disordered breathing among acute ischemic stroke patients in Brazil

2016 ◽  
Vol 19 ◽  
pp. 8-12 ◽  
Author(s):  
Millene R. Camilo ◽  
Saul V. Schnitman ◽  
Heidi H. Sander ◽  
Alan L. Eckeli ◽  
Regina M.F. Fernandes ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Sleep Disordered Breathing ◽  
Stroke Patients ◽  
Disordered Breathing

Abstract TP208: Sleep Disordered Breathing (SDB) - An Overlooked Modifiable Risk Factor in Acute Stroke Care

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Vishal Shah ◽  
Ashrai Gudlavalleti ◽  
Julius G Latorre
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Sleep Disordered Breathing ◽  
Modifiable Risk Factor ◽  
Inclusion Criteria ◽  
Risk Of Death ◽  
Disordered Breathing

Introduction: In patients with acute stroke, part of the acute management entails identifying the risk factors; modifiable or non modifiable. Early recognition of these factors is essential for optimizing therapeutic procedures, especially those with a known effective treatment. In this sense, Sleep Disordered Breathing (SDB) has also been suggested as a modifiable and independent risk factor for stroke as defined by international guidelines and some studies have demonstrated that patients with stroke and particularly Obstructive Sleep Apnea (OSA) have an increased risk of death or new vascular events. Pathogenesis of ischemic stroke in SDB is probably related to worsening of existing cardiovascular risk factors such as hypertension and hypoxia driven cardiac arrhythmia leading to higher prevalence of ischemic stroke in patients with sleep disordered breathing disease. Despite strong evidence linking SDB to ischemic stroke, evaluation for SDB is rarely performed in patients presenting with an acute ischemic stroke. Hypothesis: Evaluation of SDB is rarely performed in patients presenting with acute ischemic stroke. Methods: We performed a retrospective review of all patients above the age of 18 who were admitted to the acute stroke service at University Hospital July 2014 to December 2014. Demographic data, etiology of stroke as identified per TOAST criteria, modifiable risk factors, presenting NIHSS and frequency of testing for SDB and their results were collected. The data was consolidated and tabulated by using STATA version 14. Results: Total of 240 patients satisfied our inclusion criteria. Only 24 patients ie 10% of those who satisfied our inclusion criteria received evaluation for SDB. Out of those evaluated, 62.5% ie 15 patients out of 24 patients had findings concerning for significant desaturation. Only 2 providers out of 8 stroke physicians ie 25% tested for SDB in more than 5 patients. Conclusions: Our observations highlight the paucity in evaluation for SDB in acute ischemic stroke in a tertiary care setting. Being a modifiable risk factor, greater emphasis must be placed on evaluation for SDB in patients in patients with acute stroke. Education must be provided to all patients and providers regarding identification of these factors.

scholarly journals Interaction between Sleep-Disordered Breathing and Acute Ischemic Stroke

2013 ◽  
Vol 9 (1) ◽  
pp. 9 ◽  
Author(s):  
Seong Hwan Ahn ◽  
Jin Ho Kim ◽  
Dong Uk Kim ◽  
In Seong Choo ◽  
Hyun Jin Lee ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

Abstract TP208: Medullary Infarction is Associated with Severe Sleep Disordered Breathing

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Shuichi Fujii ◽  
Kensaku Shibazaki ◽  
Kenichiro Sakai ◽  
Junya Aoki ◽  
Junichi Uemura ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Multivariate Regression ◽  
Sleep Disordered Breathing ◽  
Multivariate Regression Analysis ◽  
Stroke Patients ◽  
Sleep Study ◽  
Respiratory Disturbance ◽  
The Relationship ◽  
Medullary Infarction ◽  
Disordered Breathing

Background and Purpose: A relationship between presence or severity of sleep disordered breathing (SDB) and site of lesion in ischemic stroke patients has been unclear. Our aim of the present study was to investigate the relationship between presence or severity of SDB and site of ischemic lesions in stroke patients. Subjects and Methods: Between April 2010 and March 2012, consecutive ischemic stroke patients within 24 hours of onset were prospectively enrolled. Ischemic lesions were identified by MRI on admission. Patient underwent sleep study to evaluate the presence and severity of SDB within 7 days after admission. SDB was defined as a respiratory disturbance index (RDI; apnea/hypopnea events per hour) ≥ 5, and severe SDB was defined as a RDI ≥ 40. We investigated the relationship between presence or severity of SDB and clinical characteristics including site of ischemic lesions. Results: A total of 214 patients (mean age 71.3, male 132) were enrolled. Supratentrial lesion was observed in 166 (77.6%) patients and right side lesion in 101 (47.2%) patients. Sites of ischemic lesions were as follows; cortex (n=11), subcortex (n=35), cortex plus subcortex (n=75), basal ganglia (n=57), thalamus (n=13), midbrain (n=3), pons (n=27), medulla (n=11), and cerebellum (n=22). Sleep study was performed at 4 days (median). The median RDI (IQR) was 20 (10-34). SDB patients were found in 187 (87%) patients. There were no significant differences in frequency of each site of lesions between SDB and non-SDB patients. Severe SDB was observed in 42 (19.6%) patients. Age (75 (70-83) vs. 72 (64-78), p=0.047), NIHSS score on admission (3 (1-10) vs. 7 (2-12), p=0.047), the frequency of atrial fibrillation (41% vs. 22%, p=0.012) and medullary lesions (12% vs. 4%, p=0.027) were significantly higher in severe SDB patients than non-severe SDB. Multivariate regression analysis demonstrated that medullary lesions (OR 5.5, 95%CI 1.41-21.8, p=0.014) was independently associated with severe SDB. Conclusions: Medullary lesion in stroke patients should be associated with severe SDB.

scholarly journals Association of Sleep Disordered Breathing with Wake-Up Acute Ischemic Stroke: A Full Polysomnographic Study

2016 ◽  
Vol 12 (04) ◽  
pp. 549-554 ◽  
Author(s):  
Pavel Šiarnik ◽  
Branislav Kollár ◽  
Zuzana Čarnická ◽  
Pavol Šurda ◽  
Katarína Klobučníková ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals Sleep-Disordered Breathing and Acute Ischemic Stroke

Stroke ◽  
2006 ◽  
Vol 37 (4) ◽  
pp. 967-972 ◽  
Author(s):  
Claudio L. Bassetti ◽  
Milena Milanova ◽  
Matthias Gugger
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals Wake-Up Sleepyhead: Unilateral Diencephalic Stroke Presenting with Excessive Sleepiness

2019 ◽  
Vol 10 (01) ◽  
pp. 145-147 ◽  
Author(s):  
R. Pradeep ◽  
Dhananjay Gupta ◽  
Anish Mehta ◽  
R. Srinivasa ◽  
Mahendra Javali ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Sleep Disordered Breathing ◽  
Reciprocal Relationship ◽  
Sleep Architecture ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Stroke Patients ◽  
Excessive Sleepiness ◽  
Sleep Abnormalities ◽  
Disordered Breathing

ABSTRACTAltered sleep architecture and stroke share a reciprocal relationship. More than half of the stroke patients display sleep abnormalities including hypersomnia, insomnia, parasomnia, periodic limb movements, or sleep-disordered breathing. Conversely, one of the major causes of severe organic hypersomnia is acute brainstem strokes, involving thalamic infarctions, which may be reversible over 6–12 months. Here, we report a patient with increased lethargy and drowsiness who was diagnosed to have a right thalamic and hypothalamic ischemic stroke.

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