Brief CommunicationDo apneas and hypopneas best reflect risk for poor outcomes after stroke?
Section snippets
Methods
Data were obtained from the Brain Attack Surveillance in Corpus Christi (BASIC) Project, an ongoing stroke surveillance study that takes place along the gulf coast of Texas. Detailed methods have been published previously [11]. Acute stroke cases are identified through active and passive surveillance among all seven acute care hospitals within Nueces County. Cases are validated, after review of source documentation, by fellowship-trained stroke physicians. Subjects are eligible for enrollment
Results
Of the 995 subjects with outcome assessments, 623 had successful ApneaLink studies. Supplementary Table 1 summarizes baseline characteristics, ApneaLink Plus measures, and outcomes for the complete and imputed (n = 995) data. The median age was 67 (interquartile range: 59, 78) and about half (52%) were women. Median time from stroke to ApneaLink Plus study was 13 days [IQR = (7, 22)]. Approximately 63% of these subjects had an REI ≥10. Correlations among the specific ApneaLink Plus variables
Discussion
This sizeable, multicenter, prospective, observational study suggests that ODI in comparison to REI has a stronger association with recurrent ischemic stroke. The association is significant for ODI but not for REI. This suggests that ODI could be a better predictor of recurrent ischemic stroke than REI. This study did not identify an HSAT measure more strongly associated than REI with post-stroke functional or cognitive outcome. Notably, despite the low frequency of central apneic events, not
Sources of funding
The project was funded by the National Institutes of Health (R01 HL098065, R01 NS070941, and R01HL126700). The funding source played no role in the decision to submit this analysis for consideration or in the interpretation of data.
Disclosures
Brown: received research grant funding from the NIH (R01HL126700, R01HL123379, R01 NS070941, R01 HL098065, U01NS099043).
Khorasani: received funding from R01HL126700.
Kim: R01HL126700, R01NS091112, R01NS038916, R01DK070869, U01DK062456, HHSM-500-2016-RFP-0039.
Chervin: received research grant funding from the NIH (R01HL126700, R01HL123379, R01 NS070941, R01 HL098065, R01 HL105999, R43 HL117421, T32HL110952, R01HD082129, U01HL125295 and U01NS099043). He has consulted for Zansors; serves as an
Acknowledgments
Part of this study was performed in the Corpus Christi Medical Center, and in CHRISTUS Spohn Hospitals, CHRISTUS Health system, in Corpus Christi, TX.
References (21)
- et al.
Ischemic stroke subtype and presence of sleep-disordered breathing: the BASIC Sleep Apnea Study
J Stroke Cerebrovasc Dis
(2015) - et al.
Frequency of sleep apnea in stroke and TIA patients: a meta-analysis
J Clin Sleep Med
(2010) - et al.
Sleep-related breathing disorders and rehabilitation outcome of stroke patients: a prospective study
Am J Phys Med Rehabil
(2003) - et al.
Sleep-disordered breathing and poor functional outcome after stroke
Stroke
(1996) - et al.
Relationship of sleep apnea to functional capacity and length of hospitalization following stroke
Sleep
(2003) - et al.
Effect of upper airway obstruction in acute stroke on functional outcome at 6 months
Thorax
(2004) - et al.
Sleep-disordered breathing is associated with recurrent ischemic stroke
Stroke
(2019) - et al.
Sleep-disordered breathing is associated with worse stroke outcomes in Mexican Americans
- et al.
The last 25 Years of obstructive sleep apnea epidemiology-and the next 25?
Am J Resp Crit Care Med
(2018) - et al.
The ignored parameter in the diagnosis of obstructive sleep apnea syndrome: the oxygen desaturation index
Turk Arch Otorhinolaryngol
(2018)
Cited by (7)
Neural network analysis of nocturnal SpO<inf>2</inf> signal enables easy screening of sleep apnea in patients with acute cerebrovascular disease
2021, Sleep MedicineCitation Excerpt :To test our hypothesis, we trained a CNN with suspected sleep apnea patients and evaluated whether this CNN could accurately estimate REI and oxygen saturation index (ODI) in patients with an acute stroke or TIA utilizing only the SpO2 signal. The SpO2 signal was selected as the CNN input because of; 1) a pulse oximeter is a part of active patient monitoring, 2) the high correlation between AHI and ODI [28], and 3) an association between ODI and recurrent ischemic stroke [29]. In addition, using sole SpO2 signal enables light measurement setup, which is practical for recordings conducted in stroke units.
Up-to-date advance in the relationship between OSA and stroke: a narrative review
2024, Sleep and BreathingDisparities in oxygen saturation and hypoxic burden levels in obstructive sleep apnoea patient’s response to oral appliance treatment
2022, Journal of Oral RehabilitationSocioeconomic inequalities in pediatric obstructive sleep apnea
2022, Journal of Clinical Sleep Medicine