Central sleep apnea is uncommon after stroke

Schütz, Sonja G.; Lisabeth, Lynda D.; Hsu, Chia‐Wei; Kim, Sehee; Chervin, Ronald D.; Brown, Devin L.

doi:10.1016/j.sleep.2020.08.025

Cited by 14 publications

(8 citation statements)

References 15 publications

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“…Regarding CSAS, the low prevalence in our study population (1.38%) was similar to that in previous studies (1.4%). 32 There is some evidence suggesting that CSAS after stroke decreases from the acute phase compared with chronic stroke. 32 In cases of comorbid OSAHS and persistent central sleep apnea, CPAP titration is recommended.…”

Section: Discussionmentioning

confidence: 99%

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High prevalence of obstructive sleep apnea syndrome in Spain’s Stroke Belt

et al. 2021

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Objective Spain’s so-called Stroke Belt is an area with high prevalence of vascular disease. We aimed to determine the prevalence of undetected obstructive sleep apnea–hypopnea syndrome (OSAHS) among patients with acute ischemic stroke (AIS) in southern Spain. Methods We conducted a cross-sectional study at the Virgen Macarena University Hospital Stroke Unit during 2018 to 2019. We included patients <72 hours after AIS with a neuroimaging lesion and performed sleep tests. Results Seventy-two patients were included. The median participant age was 72 years. Mean body mass index was 27.07 kg/m2, and 40.28% were daily alcohol drinkers. Hypertension, atrial fibrillation, ischemic cardiomyopathy, and previous stroke were detected in 63.9%, 11.1%, 15.3%, and 17.6% of patients, respectively. Polygraphy was feasible in 91.38% of patients. The prevalence of OSAHS was 84.72% (apnea–hypopnea index ≥5). Patients with moderate and severe OSAHS were more likely to be obese and to have a larger neck circumference and facial palsy. The diagnostic criteria of central sleep apnea syndrome were met in only 1.38% of patients. Conclusions The high prevalence of OSAHS found in the Spanish Stroke Belt justifies further investigation and development of a screening program as a strategy to identify patients with undetected OSAHS.

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Section: Discussionmentioning

confidence: 99%

“… 32 There is some evidence suggesting that CSAS after stroke decreases from the acute phase compared with chronic stroke. 32 In cases of comorbid OSAHS and persistent central sleep apnea, CPAP titration is recommended. For these reasons, a second sleep study was not conducted for all patients in our study.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of obstructive sleep apnea syndrome in Spain’s Stroke Belt

et al. 2021

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“…Isso pode ocorrer em altitudes tão baixas quanto 1.400 m, mas geralmente não causa sintomas até 2.500 m. (240) O AVC tem sido considerado um fator de risco para o desenvolvimento de ACS; contudo, quando são comparados os eventos centrais com os eventos obstrutivos, a AOS é muito mais frequente do que a ACS naqueles com AVC. (241,242) Outro fator de risco para o desenvolvimento de ACS é a intoxicação por opioides, pois esses diminuem a responsividade central e periférica à hipoxemia e hipercapnia no estado de vigília e no sono. (243) Embora o mecanismo exato da ACS associada ao uso crônico de opioides ainda seja desconhecido, pode ser em parte devido à alteração no drive ventilatório por conta dessa diminuição na sensibilidade quimiorreceptora.…”

Section: Apneia Central Do Sonounclassified

Brazilian Thoracic Association Consensus on Sleep-disordered Breathing

et al. 2022

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Sleep is essential for the proper functioning of all individuals. Sleep-disordered breathing can occur at any age and is a common reason for medical visits. The objective of this consensus is to update knowledge about the main causes of sleep-disordered breathing in adult and pediatric populations, with an emphasis on obstructive sleep apnea. Obstructive sleep apnea is an extremely prevalent but often underdiagnosed disease. It is often accompanied by comorbidities, notably cardiovascular, metabolic, and neurocognitive disorders, which have a significant impact on quality of life and mortality rates. Therefore, to create this consensus, the Sleep-Disordered Breathing Department of the Brazilian Thoracic Association brought together 14 experts with recognized, proven experience in sleep-disordered breathing.

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“…Notably, the high prevalence of SDB in stroke is mainly determined by OSA, being the reported prevalence of CSA approximately 12% [2]. In a recent study conducted on a large population of stroke patients tested with a home sleep apnea test [40], the prevalence of CSA was even lower (1.4%). However, the prevalence of CSA in stroke patients is probably underestimated.…”

Section: Sleep Apnea In Stroke Patients: New Onset or Pre-existing Co...mentioning

confidence: 99%

“…In fact, CSA is diagnosed exclusively when more than 50% of total apneic events are scored as central. Furthermore, most of the studies evaluating the prevalence of SDB did not score central hypopnea [40]. Since the pathogenic pathways behind OSA and CSA are different, future studies should count separately the AHI of central and obstructive events and consider a mixed respiratory pattern when these two conditions coexist.…”

Section: Sleep Apnea In Stroke Patients: New Onset or Pre-existing Co...mentioning

confidence: 99%

Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship

Brunetti

Rollo

Broccolini

et al. 2022

Curr Neurol Neurosci Rep

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Purpose of Review To elucidate the interconnection between sleep and stroke. Recent Findings Growing data support a bidirectional relationship between stroke and sleep. In particular, there is strong evidence that sleep-disordered breathing plays a pivotal role as risk factor and concur to worsening functional outcome. Conversely, for others sleep disorders (e.g., insomnia, restless legs syndrome, periodic limb movements of sleep, REM sleep behavior disorder), the evidence is weak. Moreover, sleep disturbances are highly prevalent also in chronic stroke and concur to worsening quality of life of patients. Promising novel technologies will probably allow, in a near future, to guarantee a screening of commonest sleep disturbances in a larger proportion of patients with stroke. Summary Sleep assessment and management should enter in the routinary evaluation of stroke patients, of both acute and chronic phase. Future research should focus on the efficacy of specific sleep intervention as a therapeutic option for stroke patients.

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Central sleep apnea is uncommon after stroke

Cited by 14 publications

References 15 publications

High prevalence of obstructive sleep apnea syndrome in Spain’s Stroke Belt

High prevalence of obstructive sleep apnea syndrome in Spain’s Stroke Belt

Brazilian Thoracic Association Consensus on Sleep-disordered Breathing

Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship

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