Sleep-Disordered Breathing and Acute Stroke

2009 ◽  
Vol 27 (1) ◽  
pp. 104-110 ◽  
Author(s):  
Pere Cardona Portela ◽  
Jaume Campdelacreu Fumadó ◽  
Helena Quesada García ◽  
Francisco Rubio Borrego
Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Vishal Shah ◽  
Ashrai Gudlavalleti ◽  
Julius G Latorre

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.


Neurology ◽  
2003 ◽  
Vol 61 (7) ◽  
pp. 959-963 ◽  
Author(s):  
J. Harbison ◽  
G. J. Gibson ◽  
D. Birchall ◽  
I. Zammit-Maempel ◽  
G. A. Ford

Cureus ◽  
2020 ◽  
Author(s):  
Nobuto Nakanishi ◽  
Yasuhiro Suzuki ◽  
Manabu Ishihara ◽  
Yoshitoyo Ueno ◽  
Natsuki Tane ◽  
...  

2014 ◽  
Vol 19 (1) ◽  
pp. 3-3
Author(s):  
José Haba-Rubio ◽  
Daniella Andries ◽  
Vincianne Rey-Bataillard ◽  
Patrik Michel ◽  
Mehdi Tafti ◽  
...  

2020 ◽  
Vol 30 (4) ◽  
pp. 485-492
Author(s):  
A. G. Chuchalin ◽  
T. G. Кim ◽  
L. V. Shogenova ◽  
M. Yu. Martynov ◽  
E. I. Gusev

The article presents an overview of the problem of respiratory failure in patients with acute stroke, its prevalence, leading pathophysiological factors, clinical features, and diagnostic methods. Stroke is the third leading cause of death worldwide. Stroke survivors often experience medical complications that may be the direct cause of mortality. The syndrome of respiratory failure and respiratory complication are common after stroke. The syndrome of respiratory failure syndrome of varying severity is following after stroke in 44 – 90%, often remains undervalued, undiagnosed, due to the clinical features of this category of patients. The nature of these disorders depends on the severity and site of neurological injury. Abnormality of breathing control, respiratory mechanics, and breathing pattern are common and may lead to gas exchange abnormalities or the need for respiratory support. The leading symptom is hypoxemia, which is often hidden, and may be detected by examining of arterial blood gasses (PaO2, PCO2). Stroke can lead to sleep disordered breathing such as central or obstructive sleep apnea. Sleep disordered breathing may also play a role in the pathogenesis of cerebral infarction. Venous thromboembolism, swallowing abnormalities, aspiration, and pneumonia are among the most common respiratory complications of stroke. Neurogenic pulmonary edema occurs less often but may be very dramatic. Therefore, early diagnosis, prevention and treatment are important in reducing mortality and improving functional rehabilitation.


2011 ◽  
Vol 16 (3) ◽  
pp. 759-764 ◽  
Author(s):  
José Haba-Rubio ◽  
Daniela Andries ◽  
Vincianne Rey ◽  
Patrik Michel ◽  
Mehdi Tafti ◽  
...  

2021 ◽  
Vol 10 (16) ◽  
pp. 3568
Author(s):  
Benjamin K. Petrie ◽  
Tudor Sturzoiu ◽  
Julie Shulman ◽  
Saleh Abbas ◽  
Hesham Masoud ◽  
...  

Sleep disordered breathing (SDB) is highly prevalent, but frequently unrecognized among stroke patients. Polysomnography (PSG) is difficult to perform soon after a stroke. We evaluated the use of screening questionnaires and portable sleep testing (PST) for patients with acute stroke, subarachnoid hemorrhage, or transient ischemic attack to expedite SDB diagnosis and management. We performed a single-center retrospective analysis of a quality improvement study on SDB screening of consecutive daytime, weekday, adult admissions to a stroke unit. We excluded patients who were unable to communicate and lacked available family members. Patients were screened with the Epworth Sleepiness Scale, Berlin Questionnaire, and STOP-BANG Questionnaire and underwent overnight PST and/or outpatient PSG. The 4-item STOP Questionnaire was derived from STOP-BANG for a secondary analysis. We compared the sensitivity and specificity of the questionnaires for the diagnosis of at least mild SDB (apnea hypopnea index (AHI) ≥5) on PST and correlated AHI measurements between PST and PSG using the Spearman correlation. Out of sixty-eight patients included in the study, 54 (80%) were diagnosed with SDB. Only one (1.5%) had a previous SDB diagnosis. Thirty-three patients completed all questionnaires and a PST. The STOP-BANG questionnaire had the highest sensitivity for at least mild SDB (0.81, 95% CI (confidence interval): 0.65–0.92) but a low specificity (0.33, 95% CI 0.10, 0.65). The discrimination of all questionnaires was overall poor (C statistic range 0.502–0.640). There was a strong correlation (r = 0.71) between the AHI results estimated using PST and outpatient PSG among 28 patients. The 4-item STOP Questionnaire was the easiest to administer and had a comparable or better sensitivity than the other questionnaires. Inpatient PSTs were useful for screening in the acute setting to facilitate an early diagnosis of SDB and to establish further outpatient evaluations with sleep medicine.


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