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Obstructive and Central Sleep Apnea in First Ever Ischemic Stroke are Associated with Different Time Course and
Alessia Riglietti1, Francesco Fanfulla2, Massimo Pagani3
1Department of Pulmonology, Regional Hospital of Lugano (EOC), Lugano, 6900, Switzerland.
Nature and Science of Sleep
|July 23, 2021
Summary
Sleep-disordered breathing is common after ischemic stroke. Obstructive sleep apnea prevalence increases during recovery, alongside altered baroreflex sensitivity, suggesting autonomic nervous system changes may aid stroke recovery.
Area of Science:
- Neurology
- Sleep Medicine
- Cardiology
Background:
- Sleep-related breathing disorders are prevalent in ischemic stroke patients.
- Obstructive sleep apnea is common, but central sleep apnea and periodic breathing also occur.
- Altered baroreflex responses are observed in acute stroke phases.
Purpose of the Study:
- To prospectively investigate sleep breathing patterns and baroreflex sensitivity in ischemic stroke patients.
- To describe changes from the acute phase to the recovery phase over 3 months.
Main Methods:
- A prospective 3-month follow-up physiological study was conducted on 60 ischemic stroke patients.
- Sleep breathing patterns and baroreflex sensitivity were assessed in acute and recovery phases.
Main Results:
- In the acute phase, 22.4% had normal breathing, 40.3% obstructive, 16.4% central, and 29.9% mixed patterns.
- Obstructive sleep apnea increased from 38.3% at baseline to 61.7% at follow-up.
- Changes in baroreflex sensitivity were influenced by lesion site and acute sleep disorder patterns (MANOVA p=0.005).
Conclusions:
- Down-regulation of autonomic activity, possibly via reduced vagal modulation, may aid stroke recovery.
- A temporary disconnection from cortical regulatory nodes may influence sympathetic outflow.
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