Obstructive Sleep Apnea and Stroke: Determining the Mechanisms Behind their Association and Treatment Options

Mohamed, Basma; Yarlagadda, Keerthi; Self, Zachary; Simon, Alexandra; Rigueiro, Frank; Sohooli, Maryam; Eisenschenk, Stephan; Doré, Sylvain

doi:10.1007/s12975-023-01123-x

Cited by 4 publications

(6 citation statements)

References 323 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 17 In our study, minor strokes dominated the cohort, with a median NIHSS score of 2. 1–4 Good compliance with overnight PSG completion in minor stroke might explain this finding. Our findings also indicated that even in the minor stroke population, the correlation between the NIHSS score and SDB remained.…”

Section: Discussionmentioning

confidence: 96%

“… 1–4 The association between SDB and stroke has gained increasing attention. 1 2 Obstructive sleep apnoea (OSA) is a primary manifestation of SDB in patients with acute ischaemic stroke (AIS). 1 5 Studies have demonstrated that approximately 71% of acute stroke patients suffer from OSA.…”

Section: Introductionmentioning

confidence: 99%

“… 1 2 Obstructive sleep apnoea (OSA) is a primary manifestation of SDB in patients with acute ischaemic stroke (AIS). 1 5 Studies have demonstrated that approximately 71% of acute stroke patients suffer from OSA. 6 Moderate-to-severe SDB is a known risk factor for hypertension and atrial fibrillation, leading to cerebrovascular disease and vascular dementia.…”

Section: Introductionmentioning

confidence: 99%

“…Sleep-disordered breathing (SDB) is identified as a clinical syndrome, delineated by recurrent obstruction of the upper airway, which is commonly accompanied by snoring, sleep fragmentation and intermittent hypoxemia. [1][2][3][4] The association between SDB and stroke has gained increasing attention. 1 2 Obstructive sleep apnoea (OSA) is a primary manifestation of SDB in patients with acute ischaemic stroke (AIS).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Nomogram for predicting moderate-to-severe sleep-disordered breathing in patients with acute ischaemic stroke: a retrospective cohort study

Gu,

Xie,

Liu

et al. 2024

BMJ Open

View full text Add to dashboard Cite

ObjectivesModerate-to-severe sleep-disordered breathing (SDB) is prevalent in patients with acute ischaemic stroke (AIS) and is associated with an increased risk of unfavourable prognosis. We aimed to develop and validate a reliable scoring system for the early screening of moderate-to-severe SDB in patients with AIS, with the objective of improving the management of those patients at risk.Study designWe developed and validated a nomogram model based on univariate and multivariate logistic analyses to identify moderate-to-severe SDB in AIS patients. Moderate-to-severe SDB was defined as an apnoea-hypopnoea index (AHI) ≥15. To evaluate the effectiveness of our nomogram, we conducted a comparison with the STOP-Bang questionnaire by analysing the area under the receiver operating characteristic curve.SettingLarge stroke centre in northern Shanghai serving over 4000 inpatients, 100 000 outpatients and emergency visits annually.ParticipantsWe consecutively enrolled 116 patients with AIS from the Shanghai Tenth People’s Hospital.ResultsFive variables were independently associated with moderate-to-severe SDB in AIS patients: National Institutes of Health Stroke Scale score (OR=1.20; 95% CI 0.98 to 1.47), neck circumference (OR=1.50; 95% CI 1.16 to 1.95), presence of wake-up stroke (OR=21.91; 95% CI 3.08 to 156.05), neuron-specific enolase level (OR=1.27; 95% CI 1.05 to 1.53) and presence of brainstem infarction (OR=4.21; 95% CI 1.23 to 14.40). We developed a nomogram model comprising these five variables. The C-index was 0.872, indicated an optimal agreement between the observed and predicted SDB patients.ConclusionsOur nomogram offers a practical approach for early detection of moderate-to-severe SDB in AIS patients. This tool enables individualised assessment and management, potentially leading to favourable outcomes.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nomogram for predicting moderate-to-severe sleep-disordered breathing in patients with acute ischaemic stroke: a retrospective cohort study

Gu,

Xie,

Liu

et al. 2024

BMJ Open

View full text Add to dashboard Cite

show abstract

“…In the international case-control study of patients presenting with first acute stroke called INTERSTROKE, it has been observed sleep disturbance symptoms were common and they were significantly associated with a graded increased risk of stroke [34]. The proven link between cardiovascular and cerebrovascular health [35,36] and sleep deterioration opened an obvious challenge to investigate the causality between sleep disorders and systemic inflammation, which could be the mediator of the cardio-and cerebrovascular events.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Markers and Sleep Architecture in Sleep Bruxism—A Case-Control Study

Fulek,

Wieckiewicz,

Szymanska-Chabowska

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Sleep bruxism (SB) is a common sleep-related movement behavior with a multifaceted etiology and a deficiently understood pathophysiology. A recent hypothesis suggests a link between SB and systemic inflammation. The scope of the study was to determine whether bruxers have altered sleep structure and different levels of inflammatory parameters compared to nonbruxers. Methods: A total of 83 adults underwent full-night polysomnography. The polysomnograms were evaluated using the American Academy of Sleep Medicine (AASM) guidelines. Then, the blood samples were obtained from the participants by venipuncture and the analyses were performed. The study group was divided based on bruxism episode index (BEI) into two groups: BEI ≤ 4 and BEI > 4. Results: In comparison with nonbruxers, the oxygen desaturation index (ODI) was significantly higher in severe bruxers (7.5 ± 11.08 vs. 3.33 ± 5.75, p < 0.005), as well as the arousal parameters (7.77 ± 4.68 vs. 4.03 ± 2.97, p < 0.001), and the mean oxygen desaturation (3.49 ± 0.69 vs. 3.01 ± 0.67, p < 0.05). Moreover, the differences in sleep architecture and deprivation of the deep sleep phase were observed, the non-REM sleep stage 3 was significantly shorter in severe bruxers (p < 0.03). Differences were also noted in non-REM sleep stage 1 and REM sleep phase. In the investigated group, there were no statistical differences in inflammatory cytokines levels between bruxers and nonbruxers. Conclusions: Sleep bruxism is associated with sleep structure alterations and may be associated with deep sleep phase deprivation. The inflammatory markers are not linearly correlated with the severity of sleep bruxism expressed as BEI.

show abstract

Understanding adherence to continuous positive airway pressure in patients with obstructive sleep apnea post‐stroke: A prospective study based on the Andersen model

Yang,

Wang,

et al. 2024

Nursing & Health Sciences

View full text Add to dashboard Cite

Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) post‐stroke is often problematic, despite potential benefits. This study aimed to evaluate CPAP adherence in patients with OSA post‐stroke based on the Andersen behavioral model of health services utilization. A total of 227 eligible participants were recruited from a Chinese hospital. After baseline assessment, participants were followed for 6 months to determine short‐term CPAP adherence. Those with good short‐term adherence were followed for an additional 6 months to explore long‐term adherence and influencing factors. Short‐term CPAP adherence rate was 33%. Being married or living with a partner, having an associate degree or baccalaureate degree or higher, and stronger health beliefs independently predicted short‐term CPAP adherence. Only 25% of participants from the adherent group showed good long‐term adherence. The factor associated with long‐term CPAP adherence was participants not using alcohol. Adherence to CPAP is suboptimal among patients having OSA post‐stroke. Addressing unfavorable predisposing factors and modifying health beliefs are suggested.

show abstract

Obstructive Sleep Apnea and Stroke: Determining the Mechanisms Behind their Association and Treatment Options

Cited by 4 publications

References 323 publications

Nomogram for predicting moderate-to-severe sleep-disordered breathing in patients with acute ischaemic stroke: a retrospective cohort study

Nomogram for predicting moderate-to-severe sleep-disordered breathing in patients with acute ischaemic stroke: a retrospective cohort study

Inflammatory Markers and Sleep Architecture in Sleep Bruxism—A Case-Control Study

Understanding adherence to continuous positive airway pressure in patients with obstructive sleep apnea post‐stroke: A prospective study based on the Andersen model

Contact Info

Product

Resources

About