Infarct location and sleep apnea: evaluating the potential association in acute ischemic stroke

Area of Science:

• Neurology
• Sleep Medicine
• Cardiovascular Research

Background:

• Conflicting literature exists regarding the association between obstructive sleep apnea (OSA) and stroke location.
• Previous studies have yielded inconsistent findings on whether OSA influences stroke occurrence or characteristics.

Purpose of the Study:

• To investigate the relationship between stroke location and OSA prevalence and severity in acute ischemic stroke patients.
• To determine if specific stroke locations are associated with higher OSA severity, measured by apnea-hypopnea index (AHI), arousal frequency, hypoxia, and respiratory event counts.

Main Methods:

• Utilized data from a randomized controlled trial (NCT01446913) assessing OSA diagnosis and treatment strategies in stroke patients.
• Classified stroke location using brain imaging reports (lobes, subcortical areas, brainstem, cerebellum, vascular territory).
• Employed logistic and negative binomial regression to analyze the association between stroke location and OSA presence/severity (AHI).

Main Results:

• Out of 73 patients with complete data, 79% (58 patients) were diagnosed with OSA.
• No significant association was found between any stroke location variable and the prevalence or severity of OSA in unadjusted models.
• Multivariable analysis also revealed no association between stroke location groupings and OSA presence.

Conclusions:

• OSA is highly prevalent in the majority of ischemic stroke patients.
• Stroke location is not a reliable indicator for identifying patients at higher risk of OSA.
• The findings suggest OSA likely predates the stroke, supporting polysomnography screening for all ischemic stroke patients.