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Sleep-Disordered Breathing Is Associated With Recurrent Ischemic Stroke.

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Sleep-disordered breathing (SDB) is linked to recurrent ischemic stroke but not mortality in a large population study. SDB may be a modifiable risk factor for stroke recurrence.

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brainproportional hazards modelsrecurrencesleep apnea, obstructivestroke

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Epidemiology

Background:

  • Limited population-based data exist on sleep-disordered breathing (SDB) and stroke recurrence or mortality.
  • Large, ethnically diverse population studies are needed to clarify this relationship.

Purpose of the Study:

  • To investigate the association between SDB and recurrent ischemic stroke.
  • To examine the relationship between SDB and post-stroke mortality.

Main Methods:

  • The Brain Attack Surveillance in Corpus Christ (BASIC) project identified ischemic stroke patients (2010-2015).
  • Sleep-disordered breathing was screened using the ApneaLink Plus device (REI score ≥10 defined SDB).
  • Cause-specific proportional hazards models assessed associations, adjusting for confounders.

Main Results:

  • 63% of 842 subjects had SDB, associated with male sex, Mexican American ethnicity, diabetes, and hypertension.
  • Recurrent ischemic stroke occurred in 11% and mortality in 13% over a median follow-up of 591 days.
  • Higher REI scores were associated with recurrent ischemic stroke (HR 1.02; 95% CI, 1.01-1.03) but not mortality (HR 1.00; 95% CI, 0.99-1.02).

Conclusions:

  • Sleep-disordered breathing is associated with recurrent ischemic stroke in a large population-based cohort.
  • Sleep-disordered breathing was not associated with all-cause post-stroke mortality.
  • SDB may be an important, modifiable risk factor for recurrent stroke.