J Sleep Med.  2019 Dec;16(2):88-94. 10.13078/jsm.190035.

Effect of Obstructive Sleep Apnea on the Functional Outcome of Acute Ischemic Stroke

• Han SH
• Park KY
• Kim YS
• Kim JM
• Lee SY

• KMID: 2470428
• DOI: http://doi.org/10.13078/jsm.190035

Abstract

OBJECTIVES
This study investigated the prevalence and clinical characteristics of obstructive sleep apnea (OSA) in acute ischemic stroke patients and the effect of OSA on prognosis of acute ischemic stroke.
METHODS
Forty-nine acute ischemic stroke patients with portable polysomnography (PSG) examination from 2017 to 2018 were included. Demographic data, laboratory findings, and PSG variables were collected. The severity of initial neurologic deficit was assessed using National Institutes of Health Stroke Scale (NIHSS) and functional outcome was evaluated using the modified Rankin Scale (mRS). An unfavorable prognosis three months after the onset of acute ischemic stroke was defined as an mRS ≥3. We assessed the association between with OSA severity and functional outcome using multivariate logistic regression.
RESULTS
Of 49 patients with acute ischemic stroke, 43 (87.8%) had OSA [apnea-hypopnea index (AHI)≥5/h]. Fourteen (28.6%) patients had mild OSA, 16 (32.7%) had moderate while 13 (26.5%) were having severe OSA. Univariate logistic regression showed that OSA related variables [AHI and oxygen desaturation index (ODI)] were associated with poor clinical outcome three months after stroke (mRS ≥3). Multivariate logistic regression analysis adjusted for age and initial NIHSS demonstrated that increase in AHI (adjusted odds ratio, 1.079; 95% confidence interval, 1.007-1.156, p=0.031) and ODI (adjusted odds ratio, 1.095; 95% confidence interval, 1.020-1.174, p=0.011) was associated with poor functional outcome three months after stroke.
CONCLUSIONS
OSA in patients with acute ischemic stroke is associated with poor functional outcomes.

Keyword

Obstructive sleep apnea; Stroke; Cerebral infarction; Prognosis; Disability

MeSH Terms

Cerebral Infarction
Humans
Logistic Models
National Institutes of Health (U.S.)
Neurologic Manifestations
Odds Ratio
Oxygen
Polysomnography
Prevalence
Prognosis
Sleep Apnea, Obstructive*
Stroke*
Oxygen