Sleep-disordered breathing in patients with stroke-induced dysphagia

Area of Science:

• Neurology
• Sleep Medicine
• Respiratory Medicine

Background:

• Post-stroke dysphagia is a common complication affecting patient recovery and quality of life.
• Sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA) and central sleep apnea (CSA), is prevalent in stroke survivors.
• The relationship between post-stroke dysphagia and SDB requires further investigation.

Purpose of the Study:

• To investigate the characteristics of SDB in patients with post-stroke dysphagia.
• To identify demographic, anthropometric, and clinical factors associated with SDB in this population.
• To determine the association between dysphagia severity and SDB severity.

Main Methods:

• Thirty-nine acute stroke patients with dysphagia underwent overnight polysomnography.
• Sleep-disordered breathing was quantified using the apnea-hypopnea index (AHI), obstructive apnea-hypopnea index (OAHI), and central apnea-hypopnea index (CAHI).
• Dysphagia severity was assessed using the Mann Assessment of Swallowing Ability (MASA) score, stroke severity with the NIH Stroke Scale, and functional dependence with the modified Barthel index (mBI).

Main Results:

• 97% of participants had SDB (mean AHI of 37.5 events/hr), predominantly obstructive (mean OAHI of 19.6 events/hr).
• Dysphagia severity (MASA score) was significantly associated with OAHI (p=0.006).
• AHI was associated with sex, BMI, and mBI; OAHI with MASA, sex, and BMI; and CAHI with sex and mBI.

Conclusions:

• Post-stroke dysphagia is strongly associated with obstructive sleep apnea severity.
• This association is independent of sex, functional dependence, and body mass index.
• Further research should explore the clinical implications and management strategies for SDB in post-stroke dysphagia patients.