Sleep‐disordered breathing in patients with stroke‐induced dysphagia

Estai, Mohamed; Walsh, Jennifer H.; Maddison, Kathleen J.; Shepherd, Kelly; Hillman, David R.; McArdle, Nigel; Baker, Vanessa A.; King, Stuart; Alobaidi, Zinah Abdulhameed; Bamagoos, Ahmad A.; Parry, Reece; Langdon, Claire; Trzaskowski, Robyn; Harris, Geraldine; Brookes, Kim; Blacker, David; Eastwood, Peter R.

doi:10.1111/jsr.13179

Cited by 4 publications

(5 citation statements)

References 38 publications

(92 reference statements)

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“…However, in the stable stage of stroke, this type of apnea decreases significantly, which coincides with the recovery of pharyngeal muscle function 10. The current study showed that the severity of dysphagia is related to the severity of obstructive sleep apnea 11. In addition, laryngopharyngeal paralysis can easily cause aspiration,12,13 which increased the risk of pneumonia by 3 to 5 times 14,15.…”

Section: Discussionsupporting

confidence: 52%

“…10 The current study showed that the severity of dysphagia is related to the severity of obstructive sleep apnea. 11 In addition, laryngopharyngeal paralysis can easily cause aspiration, 12,13 which increased the risk of pneumonia by 3 to 5 times. 14,15 These 2 kinds of complications can cause hypoxemia, indirectly aggravate the intracranial ischemic injury, and also aggravate the central dysfunction of visceral activities.…”

Section: Dysphagia After MI May Lead To Hypoxia and Aggravate Intracr...mentioning

confidence: 99%

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Research on Relationship Between Dysphagia and Sudden Death After Medullary Infarction

et al. 2022

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Background: Medullary infarction (MI) often leads to severe dysphagia and sudden death. We investigated whether dysphagia was associated with sudden death. Methods: Patients with MI were divided into sudden death group and nonsudden death group. Dysphagia was evaluated in 2 ways: the water-swallowing test (WST) points and the degree of dysphagia. Random undersampling (RUS), random oversampling (ROS), and synthetic minority oversampling technique (SMOTE) techniques were used to process the original data and solve the imbalance problem between 2 classes. Univariate and multivariate logistic regressions were used to analyze the association between the independent variables (WST and degree of dysphagia) and the dependent variable (sudden death or not), while the National Institutes of Health Stroke Scale (NIHSS) score was used as a control. Results: Univariate logistic regression analysis showed that for all resampling methods, both the WST and NIHSS were risk factors for sudden death after MI. For multivariable logistic regression, the fitting effect of RUS logistic regression was satisfactory, which showed the same results. The results of the univariate logistic regression analysis of dysphagia degree showed that for all resampling methods, compared with no dysphagia, both mild to moderate dysphagia degree and severe dysphagia degree were risk factors for sudden death. For multivariable logistic regressions, the logistic regressions of the original data and the RUS resampling method were satisfactory which showed the same results. Conclusions: Dysphagia is closely related to sudden death after MI. The more severe the dysphagia, the higher is the incidence of sudden death.

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Section: Discussionsupporting

confidence: 52%

Section: Dysphagia After MI May Lead To Hypoxia and Aggravate Intracr...mentioning

confidence: 99%

Research on Relationship Between Dysphagia and Sudden Death After Medullary Infarction

et al. 2022

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“…In this view, OSA+ patients are at higher risk to develop complications related to dysphagia, in particular aspiration pneumonia. Interestingly, dysphagia is often reversible within a few weeks after stroke, due to gradual recovery of pharyngeal muscle function [ 43 , 44 ]. Therefore, the sleep-disordered breathing observed in AIS may improve simultaneously with the recovery of dysphagia [ 16 , 22 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Obstructive Sleep Apnea and Atrial Fibrillation in Acute Ischemic Stroke: A Cross-Sectional Study

Brunetti

Testani

Losurdo³

et al. 2023

JPM

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Background: There is a growing body of evidence suggesting a link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). The primary objective of this study is to evaluate the association between OSA and AF in acute ischemic stroke. The secondary objective is to describe the clinical features of patients with acute ischemic stroke and concomitant OSA. Methods: We enrolled consecutive patients with acute ischemic stroke. All patients underwent full-night cardiorespiratory polygraphy. To determine if there is an association between AF and OSA, we compared the observed frequency of this association with the expected frequency from a random co-occurrence of the two conditions. Subsequently, patients with and without OSA were compared. Results: A total of 174 patients were enrolled (mean age 67.3 ± 11.6 years; 95 males). OSA and AF were present in 89 and 55 patients, respectively. The association OSA + AF was observed in 33/174 cases, which was not statistically different compared to the expected co-occurrence of the two conditions. Patients with OSA showed a higher neck circumference and body mass index, a higher prevalence of hypertension and dysphagia, and a higher number of central apneas/hypoapneas. In the multivariate analysis, dysphagia and hypertension were independent predictors of OSA. A positive correlation was observed between OSA severity, BMI, and neck circumference. The number of central apneas/hypoapneas was positively correlated with stroke severity. Conclusions: Our data suggest that OSA and AF are highly prevalent but not associated in acute stroke. Our findings support the hypothesis that OSA acts as an independent risk factor for stroke.

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“…Though several studies failed to demonstrate a direct correlation among stroke topography and SDB [43], strokes involving the central respiratory pattern generator can induce respiratory instability and, in turn, promote both central and obstructive SDB [36, 42•]. In the acute stroke, several factors compromise the patency of the upper airways, such as a weakness or incoordination of the pharyngeal [44,45], intercostal and diaphragmatic muscles [46], increased rostral fluid shift [47], and prolonged supine position [48]. Moreover, a reduced arousal response may concur to increase the length of apnea and the hypoxic burden.…”

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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Sleep‐disordered breathing in patients with stroke‐induced dysphagia

Cited by 4 publications

References 38 publications

Research on Relationship Between Dysphagia and Sudden Death After Medullary Infarction

Research on Relationship Between Dysphagia and Sudden Death After Medullary Infarction

Association of Obstructive Sleep Apnea and Atrial Fibrillation in Acute Ischemic Stroke: A Cross-Sectional Study

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

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