Changes in sleep-disordered breathing severity and post-stroke outcomes in the first year after stroke

Area of Science:

• Neurology
• Sleep Medicine
• Cardiovascular Research

Background:

• Sleep-disordered breathing (SDB) is prevalent in stroke survivors.
• SDB is linked to poorer functional, cognitive, and neurological outcomes post-stroke.
• The relationship between SDB changes and outcome improvements over time is not well understood.

Purpose of the Study:

• To investigate the association between changes in sleep-disordered breathing (SDB) and longitudinal changes in functional, cognitive, and neurological outcomes in ischemic stroke (IS) patients.
• To determine if a faster reduction in SDB severity correlates with improved post-stroke recovery.

Main Methods:

• Ischemic stroke patients were monitored for SDB using portable respiratory monitors (ApneaLink Plus) at multiple time points post-stroke.
• Sleep-disordered breathing was quantified by the respiratory event index (REI).
• Functional, cognitive, and neurological outcomes were assessed longitudinally; linear mixed models and linear regression were used to analyze changes in REI and outcomes.

Main Results:

• In fully adjusted models, a faster reduction in the respiratory event index (REI) was not significantly associated with faster improvement in functional outcomes (p=0.16).
• Similarly, no significant association was found between reduced REI and improved cognitive outcomes (p=0.51) or neurological outcomes (p=0.41).
• These findings were based on data from 482 ischemic stroke patients with at least one REI measurement.

Conclusions:

• This observational study suggests no clear association between the rate of SDB improvement and enhanced functional, cognitive, or neurological recovery in stroke survivors.
• The potential benefit of SDB treatment on stroke outcomes requires further investigation.
• Future research should explore whether therapeutic interventions for SDB can positively impact recovery trajectories in this population.