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Sleep-disordered breathing and poor functional outcome after stroke

D C Good1, J Q Henkle, D Gelber

  • 1Department of Neurology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1078, USA.

Stroke
|February 1, 1996
PubMed
Summary

Sleep-disordered breathing (SDB) is common after stroke and linked to worse outcomes. Addressing SDB may improve recovery and reduce mortality in stroke patients.

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Cardiorespiratory Medicine

Background:

  • Sleep-disordered breathing (SDB) prevalence and its impact on post-stroke recovery are not fully understood.
  • Recent stroke patients require objective evaluation for SDB and its clinical associations.

Purpose of the Study:

  • To determine the prevalence of SDB in recent stroke patients.
  • To investigate the association between SDB and unfavorable clinical outcomes post-stroke.

Main Methods:

  • 47 recent ischemic stroke patients underwent overnight oximetry; 19 also had polysomnography.
  • Data collected included medical/sleep history, stroke location, neurological deficit, and snoring/sleepiness.
  • Functional outcomes measured by Barthel Index (BI) and discharge disposition.

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Main Results:

  • SDB prevalence was high, with 32% having a desaturation index (DI) > 10.
  • Oximetry measures of SDB correlated with lower BI scores and poorer return-home rates.
  • Polysomnography confirmed severe SDB in 95% of patients, primarily obstructive sleep apnea.

Conclusions:

  • SDB is common in stroke survivors and associated with worse functional outcomes and higher 1-year mortality.
  • SDB, particularly obstructive sleep apnea, may be an independent predictor of poor recovery.
  • Snoring history suggests SDB often precedes stroke, highlighting a potential therapeutic target.