Indian Journal of Sleep Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  19 (2024)
Volume  18 (2023)
Volume  17 (2022)
Volume  16 (2021)
Volume  15 (2020)
Volume  14 (2019)
Volume  13 (2018)
Volume  12 (2017)
Volume  11 (2016)
Volume  10 (2015)
Volume  9 (2014)
Volume  8 (2013)
Volume  7 (2012)
Volume  6 (2011)
Volume  5 (2010)
Volume  4 (2009)
Volume  3 (2008)
Volume  2 (2007)
Volume  1 (2006)
Related articles

VOLUME 9 , ISSUE 3 ( July-September, 2014 ) > List of Articles

ORIGINAL ARTICLE

Clinical and polysomnographic features of patients with OSAHS versus patients of stroke detected to have OSA

Garima Shukla, Anupama Gupta, Vinay Goyal, Achal Srivastava, Madhuri Behari

Keywords : Stroke, Obstructive sleep apnea.

Citation Information : Shukla G, Gupta A, Goyal V, Srivastava A, Behari M. Clinical and polysomnographic features of patients with OSAHS versus patients of stroke detected to have OSA. Indian Sleep Med 2014; 9 (3):107-112.

DOI: 10.5958/0974-0155.2014.01111.5

License: NA

Published Online: 01-06-2018

Copyright Statement:  NA


Abstract

Objective: Obstructive sleep apnea (OSA) is commonly found in patients with stroke; however, most of these patients are undiagnosed because they do not seekhelp for the same. As part of a prevalence study, we conducted polysomnography (PSG) recordings in consecutive patients of stroke presenting to our department. We conducted this comparative study to assess for any clinical and PSG differences between these patients and those directly presenting to our sleep disorders clinicfor OSA. Methods: We analyzed various clinical and PSG features of consecutive patients of stroke with sleep-disordered breathing admitted between September 2009 and February 2010 consecutively. PSG was carried out after 6 weeks or more of the stroke for all patients. An equal number of patients presenting with sleep apnea at our sleep disorders clinic, during the same period, formed the control population. Results: We included 12 male patients of stroke with sleep-disordered breathing[apnea– hypopnea index (AHI) >5] on PSG and compared them with 12 male patients who had presented for OSA, confirmed on PSG (AHI>5).We found no significant difference in sleep architecture and respiratory parametersbetween these two groups. However, we found more patientswith body mass index of >24 kg/m2among those seeking help for OSA (n=8) versus those with stroke and OSA (n=3). The former also had significantly higher Epworth sleepiness scale score(p =0.006). Conclusion: Patients of stroke found to have OSA are less sleepy in daytime as compared to those presenting for OSA and less likely to be as obese as the latter, despite the severity of sleep apnea and associated sleep disturbances being similar.

PDF Share
  1. NJ Douglas. Clinician's guide to sleep medicine :2002
  2. Bassetti CL, Milanova M, Gugger M. Sleep-disordered breathing andacute ischemic stroke: diagnosis, risk factors, treatment, evolution, andlong-term clinical outcome. Stroke. 2006;37:967–972.
  3. Bassetti C, Aldrich M, Chervin R, Quint D.Sleep apnea in patient with transient ischemic attack and stroje. Neurology 1996;47:1167-1173.
  4. Dyken ME, Somers VK, Yamada T, et al. Investigating the relationship between stroke and obstructive sleep apnea. Stroke 1996;27:401-407.
  5. Parra O, Arboix A, Bechich S. Time course of sleep related breathing disorders in first ever stroke and transient ischemic attack. Am J Respir Crit Med 2000;161:375-380.
  6. Arzt M, Young T, Finn L, Skatrud JB, Bradley TD. Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit. Care Med. 2005;172:1447–1451.
  7. Munoz R, Duran-Cantolla J, Martinez-Vila E, Gallego J, Rubio R, Aizpuru F, De La Torre G. Severe sleep apnea and risk of ischemic stroke in the elderly. Stroke. 2006;37:2317–2321.
  8. Capampangan D J, Wellik KE, Parish JM, Aguilar MI, Snyder CR, Wingerchuk, Demaerschalk BM.Is obstructive sleep apnea an independent risk factor for stroke?A clinically upraised topic. Neurologist 2010 jul;16(4):269-273.(3)
  9. Calhoun DA, Harding SM. Sleep and hypertension. Chest 2010;138(2):434-443.
  10. E. tasali, B. Mokhlesi, and E.Van Cauter, “Obstructive sleep apnea and type 2 diabetes: interacting epidemics. Chest 2008;133:496-506.
  11. Drager LF, Jun J, Polotsky VY.Obstructive sleep apnea and dyslipidemia : implication for atherosclerosis. Curr opin endocrinol diabetes obes 2010;17(2):161-165.
  12. Martinez-Garcia MA, Soler-Cataluna JJ, Ejarque-Martinez L, Soriano Y, Roman-Sanchez P, Illa FB, Canal JM, Duran- Cantolla J. Continuouspositive airway pressure treatment reduces mortality in ischemic strokepatients with obstructive sleep apnea: a 5-year follow-up study. Am JRespir Crit Care Med. 2009;180:36–41.
  13. Parra O, Arboix A, Montserrat JM, Quinto L, Bechich S, Garcia-Eroles L.Sleep-related breathing disorders: Impact on mortality of cerebrovasculardisease. Eur Respir J. 2004;24:267–272.
  14. Good DC, Henkle JQ, Gelber D, Welsh J, Verhulst S. Sleepdisorderedbreathing and poor functional outcome after stroke. Stroke. 1996;27:252–259.
  15. Balfors EM, Franklin KA. Impairment of cerebral perfusion duringobstructive sleep apneas. Am J Respir Crit Care Med. 1994;150:1587–1591.
  16. Johns MW. A new method for measuring daytime sleepiness: theEpworth Sleepiness Scale. Sleep. 1991;14:540 –545.
  17. Jonson KG, Johnson DC.Frequency of sleep apnea in stroke and TIA patients: Meta-analysis. Jclin sleep med 2010 Apr 15;6(2):131-137.
  18. Michael Arzt, Terry Young, Paul E. Peppard, Laurel Finn, Clodagh M. Ryan, Mark Bayley, T. Douglas Bradley. Dissociation of obstructive sleep apnea from hypersomnolence and obesity in patient with stroke. Stroke. 2010;41:e129-134.
  19. Wessendorf TE, Teschler H, Wang YM, Konietzko N, Thilmann AF. Sleep-disordered breathing among patients with first-ever stroke. J Neurol. 2000;247:41– 47.
  20. Sandberg O, Franklin KA, Bucht G, Eriksson S, Gustafson Y. Nasalcontinuous positive airway pressure in stroke patients with sleep apnoea:a randomized treatment study. Eur Respir J. 2001;18:630–634.
  21. Wessendorf TE, Wang YM, Thilmann AF, Sorgenfrei U, Konietzko N Teschler H. Treatment of obstructive sleep apnea with nasal continuous positive airway pressure in stroke. Eur Respir J 2001;18:623-629.
  22. Punjabi NM, Bendeen-Roche K, Young T. Predictor of objective sleep tendency in general population. Sleep 2003;26:278-683.
  23. Bennett LS, Stradling JR, Davies RJ.A behavioural test to assess day time sleepiness in obstructive sleep apnea. J. sleep research 1997;6:142-145.
  24. Duran J, Esnaola S, Rubio R, Iztueta A, Obstructive sleep apnea-hypopnea and related clinical features in population based sample of aged 30- 70. Am j Respir Crit care med 2001;163:685-689.
  25. Young T, Shahar E, Nieto FJ, Redline S, Newmen AB, Gottlieb DJ, Walsleben JA, Finn L, Enright P, Samet JM. Predictors of sleep disordered breathing in community dwelling adults: Sleep heart health study. Arch intern med 2002;162:893-900.
  26. Alex R., Manchikatla, S., Machiraju, K., Altuwaijri, E., Watenpaugh, D. E., Zhang, R., & Behbehani, K. Effect of apnea duration on apnea induced variations in cerebral blood flow velocity and arterial blood pressure. In Engineering in Medicine and Biology Society (EMBC), 2014(August).36th Annual International Conference of the IEEE (pp. 270-273). IEEE.
  27. Willie C. K., Ainslie, P. N., Drvis, I., MacLeod, D. B., Bain, A. R., Madden, D., Maslov P.Z., Dujic, Z. Regulation of brain blood flow and oxygen delivery in elite breath-hold divers. Journal of Cerebral Blood Flow & Metabolism, 2015. 35(1), 66-73.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.