Ischemic Stroke Subtype and Presence of Sleep-disordered Breathing: The BASIC Sleep Apnea Study

Background Little is known about the prevalence of sleep-disordered breathing (SDB) across ischemic stroke subtypes. Given the important implications for SDB screening, we tested the association between SDB and ischemic stroke subtype in a population-based study. Methods Within the Brain Attack Surv...

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Published in:Journal of stroke and cerebrovascular diseases 2015-02, Vol.24 (2), p.388-393
Main Authors: Brown, Devin L., MD, Mowla, Ashkan, MD, McDermott, Mollie, MD, Morgenstern, Lewis B., MD, Hegeman, Garnett, RPSGT, Smith, Melinda A., DRPH, Garcia, Nelda M., BS, Chervin, Ronald D., MD, MS, Lisabeth, Lynda D., PHD
Format: Article
Language:English
Subjects:
Aged
Body Mass Index
Brain Ischemia - classification
Brain Ischemia - complications
Brain Ischemia - physiopathology
Cardiovascular
epidemiology
Female
Humans
Ischemic stroke
Male
Middle Aged
Neurology
Polysomnography
Risk Factors
sleep apnea
Sleep Apnea Syndromes - complications
Sleep Apnea Syndromes - physiopathology
sleep-disordered breathing
Stroke - classification
Stroke - complications
Stroke - physiopathology
stroke subtype
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Summary:Background Little is known about the prevalence of sleep-disordered breathing (SDB) across ischemic stroke subtypes. Given the important implications for SDB screening, we tested the association between SDB and ischemic stroke subtype in a population-based study. Methods Within the Brain Attack Surveillance in Corpus Christi Project, ischemic stroke patients were offered SDB screening with the ApneaLink Plus (n = 355). A neurologist assigned Trial of the ORG 10172 in Acute Stroke Treatment subtype (with an additional category for nonlacunar infarctions of unknown etiology) using hospital records. Unadjusted and adjusted (demographics, body mass index, National Institutes of Health Stroke Scale, diabetes, history of stroke/transient ischemic attack) logistic and linear regression models were used to test the association between subtype and SDB or apnea–hypopnea index (AHI). Results Median age was 65%, and 55% were men; 59% were Mexican American. Median time from stroke onset to SDB screen was 13 days (interquartile range [IQR] 6, 21). Overall, 215 (61%) had SDB (AHI ≥ 10). Median AHI was 13 (IQR 6, 27). Prevalence of SDB by subtype was cardioembolism, 66%; large-artery atherosclerosis, 57%; small-vessel occlusion, 68%; other determined, 50%; undetermined etiology, 58%; and nonlacunar stroke of unknown etiology, 63%. Ischemic stroke subtype was not associated with SDB in unadjusted ( P  = .72) or adjusted models ( P  = .91) models. Ischemic stroke subtype was not associated with AHI in unadjusted ( P  = .41) or adjusted models ( P  = .62). Conclusions In this population-based stroke surveillance study, ischemic stroke subtype was not associated with the presence or severity of SDB. Sleep-disordered breathing is likely to be present after ischemic stroke, and the subtype should not influence decisions about SDB screening.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2014.09.007