Ischemic stroke location, sleep disordered breathing and sleep: Intermediate analysis of an observational prospective cohort - 25/09/20
Résumé |
Introduction |
Sleep disordered breathing (SDB) and ischemic stroke (IS) are intertwined pathologies. The topography of IS may interacts with SDB (vigilance, ventilatory and upper airway control).
Objective |
To evaluate the association between stroke location and SDB after a first IS.
Method |
Prospective monocentric cohort of patients aged 18–85years, hospitalized in the Intensive Care Stroke Unit for a first IS, without any past neurovascular or sleep history. Stroke location was determined on the diagnostic brain imaging (magnetic resonance imaging or computerized tomography scan). At three months post-stroke (median delay [Q1;Q3]=134days [97;227]), patients underwent a clinical examination including validated sleep-related questionnaires and a full-night polysomnography (PSG), performed according to AASM recommendations.
Results |
One hundred and forty-two patients were included. Patients were classified according to the absence or the presence of SDB [Apnea-Hypopnea Index (AHI)≥15 events/hour of sleep]. Among them 53% had a SDB with a median AHI at 28/h [21; 43] (52% obstructive, 25% coexistent, 23% central). Post-IS patients were slightly symptomatic and did not differed (for SDB and non-SDB respectively, Epworth Sleepiness Scale 8 [4; 12] vs. 6 [4; 10] and Pichot Fatigue scale 8 [3; 18] vs. 11 [4; 20]). SDB patients were older (65years old [55; 71] vs. 53 [48; 63]), and predominantly male (71%). Comorbidities were similar in both groups except for atrial fibrillation that was more frequent in the SDB group (14 (19%) vs 3 (5%), P=0.01). The macrostructure of sleep was affected by SDB (in minute, light sleep=16 [8; 31] vs 9.6 [5; 22] P=0.01 and slow wave sleep=4 [0; 9] vs 12 [5; 17] P<0.001). The cerebellar lesions were more frequent in the SDB group: 19% vs 3% P=0.003.
Conclusion |
Those preliminary results suggest that cerebellar location might be associated with moderate to severe SDB. Moreover, post-stroke patients with IS were more prone to have atrial fibrillation.
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Vol 12 - N° 2-4
P. 225-226 - octobre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.