Stroke: sleep apnoea severity tied to early neurological deterioration risk

  • Yoon CW & al.
  • J Stroke Cerebrovasc Dis
  • 22 Nov 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This study found that sleep apnoea (SA) is common in patients with acute ischaemic stroke (AIS) and SA severity is associated with an increase in the rate of early neurological deterioration (END).

Why this matters

  • Findings suggest that early screening for SA could be considered in patients with AIS.

Study design

  • Study of 307 patients (mean age, 63.5±12.2 years) with AIS who were admitted ≤72 hours of symptoms onset during 2014-2018.
  • Funding: Inha University Hospital.

Key results

  • A total of 254 (83.3%) AIS patients had SA (apnoea-hypopnea index [AHI] ≥5 per hour), and out of these:
    • 114 (37.4%) had mild SA (AHI, 5-14 per hour),
    • 59 (19.3%) had moderate SA (AHI, 15-29 per hour) and
    • 81 (26.6%) had severe SA (AHI, ≥30 per hour).
  • Total 36 (11.8%) patients experienced END:
    • 2 of the 51 (3.9%) patients without SA and
    • 34 of the 254 (14.4%) patients with SA.
  • The prevalence rate of END increased with the degree of SA (for all Ptrend=.010):
    • no SA group: 2.0%,
    • mild SA group: 7.9%,
    • moderate SA group 13.6% and
    • severe SA group 21.0%.
  • AHI independently predicted END in patients with AIS (OR, 1.024; 95% CI, 1.006-1.042; P=.008).

Limitations

  • Possible selection bias.

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