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.

Abstract 2457: Atrial Fibrillation is Associated with Severe Sleep Disordered Breathing TIA and Stroke Patients

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Kensaku Shibazaki ◽  
Kazumi Kimura ◽  
Junichi Uemura ◽  
Kenichiro Sakai ◽  
Shuichi Fuii
Keyword(s):  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Multivariate Regression ◽  
Sleep Disordered Breathing ◽  
Japanese Patients ◽  
Multivariate Regression Analysis ◽  
Stroke Patients ◽  
Sleep Study ◽  
Factors Associated ◽  
Disordered Breathing

Background and Purpose Sleep disordered breathing (SBD) was reported to be a risk factor for cerebrovascular disease. We investigated the frequency of SDB in Japanese patients with acute transient ischemic attack (TIA) and stroke and the factors associated with severe SDB in Japan. Methods Between May 2010 and April 2011, we prospectively enrolled TIA and stroke patients within 24 hours of onset and performed sleep study up to 7 days after admission. SBD was defined as respiratory disturbance index (RDI: apnea or hypopnea event per hour) ≥5. Patients were divided into 2 groups according to the RDI value as follows: ≥30(severe) and <30(none or non-severe). We demonstrated the frequency of SDB and the factors associated with severe SDB were investigated by multivariate regression analysis. Results A total of 150 patients (92 males; mean age, 72.8 years) were enrolled in this study; 28 had TIA and 122 had stroke. The mean time from admission to sleep study was 4 days. Mean RDI was 22.2±17.6. SDB was observed in 126(84%) patients. Frequencies of SDB were as follows: 21(75%) patients in TIA, 105(86%) in stroke [8/10(80%) in large artery atherosclerosis, 14/14(100%) in small vessel occlusion, 37/41(90%) in cardioembolism, 46/57(81%) in other cause of stroke/undetermined]. Severe SDB was observed in 44 (29%) patients; 21% in TIA and 31% in stroke. Frequencies of male (75% for the severe SDB group vs. 56% for the non-severe SDB group, p=0.027), atrial fibrillation (39% vs. 23%, p=0.045), body mass index (23.8±3.8 vs. 22.3±3.8, p=0.043), and neck circumference (37.8±4.3 vs. 35.8±4.2, p=0.012) were significantly higher in the severe SDB than in the non-severe SDB. Metabolic syndrome (36% vs. 21%, p=0.057) and waist circumference (88.9±9.8 vs. 85.5±9.3, p=0.080) showed a tendency toward higher in the severe SDB group than in the non-severe SDB group. There were no significant differences in age, prior stroke, vascular risk factors, Glasgow Coma Scale, and NIHSS score on admission. On multivariate regression analysis, atrial fibrillation (odds ratio, 2.5; 95% confidence interval, 1.079-5.836, p=0.0326) was found to be independently associated with severe SDB. Conclusions Most Japanese patients with acute TIA and stroke had SDB, and the presence of atrial fibrillation was associated with severe SDB.

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.

Are questionnaires reliable in diagnosing sleep-disordered breathing in university students?

2017 ◽  
Vol 131 (11) ◽  
pp. 965-971 ◽  
Author(s):  
E Migacz ◽  
A Wichniak ◽  
W Kukwa
Keyword(s):  
Young Adults ◽  
University Students ◽  
Epworth Sleepiness Scale ◽  
Sleep Disordered Breathing ◽  
Diagnostic Tools ◽  
Berlin Questionnaire ◽  
Sleep Study ◽  
Symptom Evaluation ◽  
Respiratory Disturbance ◽  
Disordered Breathing

AbstractObjective:This study aimed to screen young adults for sleep-disordered breathing, and compare those with high and low risk for sleep-disordered breathing.Methods:A survey based on the Berlin questionnaire was completed by 330 university students, and the results were used to divide them into sleep-disordered breathing positive and sleep-disordered breathing negative groups. A representative group was selected from each cohort (positive group,n= 16; negative group,n= 21), and assessed with sleep study, ENT examination, the Nose Obstruction Symptom Evaluation scale, and the Epworth Sleepiness Scale.Results:Sleep-disordered breathing prevalence was 11.2 per cent in the questionnaire and 24 per cent according to the sleep study. The sleep-disordered breathing positive and negative groups significantly differed in terms of coexisting sleep-disordered breathing symptoms. There were no significant differences between the positive and negative groups with regard to sleep study parameters (apnoea/hypopnoea index, respiratory disturbance index, oxygen desaturation index, snoring intensity) and the Epworth Sleepiness Scale.Conclusion:Subjective and objective diagnostic tools revealed that sleep-disordered breathing is a common problem among young adults.

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

Association between Sleep Disordered Breathing and Nighttime Driving Performance in Mild Cognitive Impairment

2017 ◽  
Vol 23 (6) ◽  
pp. 502-510 ◽  
Author(s):  
Nathan Cross ◽  
Zoe Terpening ◽  
Shantel L. Duffy ◽  
Simon J.G. Lewis ◽  
Ron Grunstein ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sleep Disordered Breathing ◽  
Driving Simulator ◽  
Driving Performance ◽  
Driving Ability ◽  
Sleep Study ◽  
The Relationship ◽  
Disordered Breathing

AbstractObjectives:The effect of sleep disordered breathing (SDB) on driving performance in older adults has not been extensively investigated, especially in those with mild cognitive impairment (MCI). The aim of this study was to examine the relationship between severity measures of SDB and a simulated driving task in older adults with and without MCI.Methods:Nineteen older adults (age ≥50) meeting criteria for MCI and 23 age-matched cognitively intact controls underwent neuropsychological assessment and a driving simulator task in the evening before a diagnostic sleep study.Results:There were no differences in driving simulator performance or SDB severity between the two groups. In patients with MCI, a higher oxygen desaturation index (ODI) was associated with an increased number of crashes on the simulator task, as well as other driving parameters such as steering and speed deviation. Poorer driving performance was also associated with poorer executive functioning (set-shifting) but the relationship between ODI and crashes was independent of executive ability.Conclusions:While driving ability did not differ between older adults with and without MCI, oxygen saturation dips in MCI were related to worse driving performance. These results suggest that decreased brain integrity may render those with SDB particularly vulnerable to driving accidents. In older adults, both cognition and SDB need to be considered concurrently in relation to driving ability. (JINS, 2017,23, 502–510)

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