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02.09.2021 | Sleep Breathing Physiology and Disorders • Original Article

Sleep-disordered breathing and cerebral small vessel disease—acute and 6 months after ischemic stroke

verfasst von: Sofie Amalie Simonsen, Adam Vittrup Andersen, Anders Sode West, Frauke Wolfram, Poul Jennum, Helle K. Iversen

Erschienen in: Sleep and Breathing | Ausgabe 3/2022

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Abstract

Purpose

Sleep-disordered breathing (SDB) occurs frequently after stroke and is associated with poor functional outcome and increased mortality. The purpose of this study was to detect changes in SDB over time after acute ischemic stroke and investigate relationships between SDB and stroke etiologies with focus on cerebral small vessel disease.

Methods

From May 2015 to August 2016, we conducted an observational study of 99 patients with mild to moderate stroke (median age: 68 years, range 36–88; 56% men). Polysomnography was performed within 7 days of stroke onset (n = 91) and after 6 months (n = 52). The strokes were classified using the etiological TOAST classification. Total small vessel disease (SVD) scores were calculated based on MRIs.

Results

SDB, defined as an apnea–hypopnea index (AHI) ≥ 15, was found in 56% of patients in the acute state and in 44% at follow-up. AHI decreased over time (median change 4.7, 95% confidence interval [95% CI] 0.5–8.9; p = 0.03). Patients with AHI ≥ 15 in both the acute state and at follow-up had higher SVD score at follow-up (p = 0.003). AHI was not associated with ischemic stroke subgroups according to the TOAST classification.

Discussion

In conclusion, 6 months after stroke, AHI decreased, but 44% still had AHI ≥ 15. Persistent SDB in both the acute state and at follow-up was associated with a higher SVD score, but not to the TOAST subgroups. SDB evaluation should be offered to stroke patients, and the effect of SDB on cerebral small vessel disease needs to be further investigated using the well-defined SVD score.

Trial registration

clinicaltrials.gov NCT02111408, April 11, 2014

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Titel: Sleep-disordered breathing and cerebral small vessel disease—acute and 6 months after ischemic stroke
verfasst von: Sofie Amalie Simonsen
Adam Vittrup Andersen
Anders Sode West
Frauke Wolfram
Poul Jennum
Helle K. Iversen
Publikationsdatum: 02.09.2021
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 3/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-021-02482-1

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Sleep-disordered breathing and cerebral small vessel disease—acute and 6 months after ischemic stroke