Related Experiment Video
Updated: Dec 28, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Prospective study of sleep-disordered breathing in 28 patients with acute unilateral lateral medullary infarction
Katja Pavšič1,2, Janja Pretnar-Oblak3,4, Fajko F Bajrović3,4,5
1Department of Vascular Neurology and Intensive Therapy, University Medical Center Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia. katja.pavsic@kclj.si.
Objective:
Acute unilateral lateral medullary infarction (ULMI) is complicated by respiratory failure in 2-6% of patients. However, studies investigating milder respiratory disorders not leading to overt respiratory failure, i.e., sleep-disordered breathing (SDB) and its outcome, are lacking. The aim of our study was to identify and prospectively follow SDB in acute ULMI.
Methods:
We prospectively followed 28 patients with MRI-confirmed acute ULMI. Polysomnography (PSG) was performed 1-3 times in the acute phase (at 1-4, 5-10, and 14-21 days after onset of symptoms) and after 3-6 months. PSG recordings in the acute phase were analyzed and compared to the follow-up.
Results:
Apnea-hypopnea index (AHI) ≥ 5/h, AHI ≥ 15/h, and AHI ≥ 30/h in the acute phase were observed in 22 (79%), 19 (68%), and 10 (36%) patients, respectively. CSA, OSA, mixed CSA/OSA, or multiple interchanging SDB types were observed in the acute phase in 12 (43%), 2 (7%), 2 (7%), and 6 (21%) patients, respectively. Peak AHI varied in individual patients (median at 7 (3-14) days after onset). At follow-up, AHI and central AHI tended to decrease (p = 0.007, p = 0.003, respectively), obstructive AHI did not change (p = 0.396). Sleep architecture partially improved with significantly higher percentage of N2 and lower percentage of wakefulness after sleep onset (p = 0.007, p = 0.012, respectively).
Conclusions:
Our data show that SDB, particularly CSA, is common in the acute phase of ULMI and that the frequency of central events decreases in the subacute phase. Further studies are needed to clarify the clinical significance and possible treatment options of SDB in these patients.
Insights
Sleep-disordered breathing (SDB), especially central sleep apnea (CSA), is common in acute unilateral lateral medullary infarction (ULMI). SDB frequency decreases in the subacute phase, warranting further clinical investigation.
Area of Science:
- Neurology
- Sleep Medicine
- Cardiorespiratory Medicine
Background:
- Acute unilateral lateral medullary infarction (ULMI) can lead to respiratory complications.
- While overt respiratory failure is documented, milder sleep-disordered breathing (SDB) in ULMI patients remains understudied.
Purpose of the Study:
- To identify and prospectively monitor sleep-disordered breathing (SDB) in patients following acute unilateral lateral medullary infarction (ULMI).
Main Methods:
- Prospective follow-up of 28 patients with MRI-confirmed acute ULMI.
- Multiple polysomnography (PSG) recordings in the acute phase (days 1-21) and at 3-6 months post-onset.
- Analysis and comparison of acute phase PSG data with follow-up PSG findings.
Main Results:
- High prevalence of SDB in acute ULMI: 79% had an apnea-hypopnea index (AHI) ≥5/h.
- Central sleep apnea (CSA) was the predominant type, observed in 43% of patients.
- AHI and central AHI decreased significantly by follow-up, while obstructive AHI remained unchanged.
Conclusions:
- Sleep-disordered breathing, particularly CSA, is highly prevalent in the acute phase of ULMI.
- A decrease in central events is observed in the subacute phase.
- Further research is necessary to determine the clinical significance and optimal management strategies for SDB in ULMI patients.
