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Sleep apnea in patients with hemispheric stroke
1Pulmonary and Critical Care Section, Yale University School of Medicine, New Haven, CT 06520-8057.
Archives of Physical Medicine and Rehabilitation
|January 1, 1995
Summary
Cerebral stroke significantly disrupts sleep patterns and breathing, leading to sleep apnea. Patients with hemispheric stroke experience abnormal sleep architecture and increased respiratory events, requiring investigation for sleep-disordered breathing.
Area of Science:
- Neurology
- Sleep Medicine
- Respiratory Medicine
Background:
- Cerebrovascular accidents (strokes) impacting the brainstem are known to cause sleep apnea.
- The effects of hemispheric stroke on sleep and breathing are less understood.
- Diffuse cerebral symptoms post-hemispheric stroke can mimic sleep apnea symptoms.
Purpose of the Study:
- To investigate sleep and breathing patterns in patients with hemispheric stroke without brainstem lesions or prior sleep-disordered breathing.
- To compare polysomnography data between stroke patients and a matched control group.
Main Methods:
- Polysomnography was conducted on 10 patients within one year of hemispheric stroke.
- Data were compared to a control group matched for age, BMI, hypertension, and smoking history.
- Analysis focused on sleep architecture and respiratory event indices.
Main Results:
- Stroke patients exhibited abnormal sleep architecture, with reduced slow-wave sleep and REM sleep compared to controls.
- Sleep fragmentation was evident due to increased respiratory disturbances.
- Stroke patients had a significantly higher respiratory disturbance index (52 events/hour vs. 3 events/hour in controls), predominantly obstructive apneas with oxygen desaturations and arousals.
Conclusions:
- Hemispheric stroke can lead to sleep-disordered breathing, likely due to impaired upper airway muscle control during sleep.
- Patients with stroke presenting with diffuse cerebral symptoms should be evaluated for sleep-disordered breathing.