Prevalence and Detection of Obstructive Sleep Apnea Early after Stroke

Area of Science:

• Neurology
• Sleep Medicine
• Rehabilitation Medicine

Background:

• Obstructive sleep apnea (OSA) significantly hinders post-stroke recovery.
• Early identification of undiagnosed OSA is crucial for optimizing patient outcomes.
• This study addresses the prevalence and screening of OSA in the acute stroke phase.

Purpose of the Study:

• To determine the prevalence of undiagnosed obstructive sleep apnea (OSA) in patients during the early stages of stroke recovery.
• To introduce and validate a simple screening tool, the BASH tool, for identifying individuals at high risk for OSA post-stroke.

Main Methods:

• A cross-sectional descriptive study included 123 adult stroke patients in inpatient rehabilitation approximately 15 days post-stroke.
• Exclusion criteria included pre-existing OSA, other neurological conditions, and inability to ambulate independently.
• Overnight oximetry measured the oxygen desaturation index (ODI); the BASH tool (BMI >=35, Age >=50, Sex=Male, Hypertension=Yes) was developed and analyzed using ROC curve analysis.

Main Results:

• The study found a 22% prevalence of undiagnosed OSA among the participants.
• Receiver operating characteristic (ROC) curve analysis demonstrated that a BASH score of 3 or higher effectively predicts the presence of OSA (AUC=0.746, p<0.001).
• The BASH tool achieved a sensitivity of 0.778 and a specificity of 0.656 for OSA detection.

Conclusions:

• A significant proportion of stroke survivors have undiagnosed obstructive sleep apnea (OSA) in the early recovery phase.
• The BASH tool demonstrates effectiveness as a screening method for OSA in this population.
• Early OSA detection and intervention post-stroke may mitigate negative impacts on functional recovery.