Sleep-disordered breathing among acute ischemic stroke patients in Brazil

Area of Science:

• Neurology
• Sleep Medicine
• Public Health

Background:

• Sleep-disordered breathing (SDB) is prevalent in acute stroke patients and linked to adverse outcomes.
• Limited data exists on SDB prevalence and impact in developing countries.

Purpose of the Study:

• To determine the frequency and severity of SDB in Brazilian acute ischemic stroke patients.
• To identify clinical and laboratory predictors of SDB.
• To evaluate the association between sleep apnea and functional outcomes post-stroke.

Main Methods:

• Prospective evaluation of 69 first-ever acute ischemic stroke patients.
• Polysomnography performed on the first night post-symptom onset.
• Functional outcome assessed using the modified Rankin Scale (mRS) at six months.

Main Results:

• A high frequency of SDB was observed, with a mean apnea-hypopnea index (AHI) of 37.7 ± 30.2.
• 76.8% of patients had AHI ≥ 10, and 47.8% had severe sleep apnea.
• Age and hematocrit predicted SDB; age, BMI, and hematocrit predicted severe SDB.
• NIH Stroke Scale and severe sleep apnea were independently associated with poor functional outcome (mRS > 2).

Conclusions:

• Acute ischemic stroke patients in Brazil exhibit a high prevalence of SDB.
• Severe sleep apnea is an independent predictor of poor long-term functional recovery after stroke in this population.