Background and Purpose We aimed to prospectively determine whether the
incidence of obstructive sleep apnea in patients with recent stroke w
as significantly different from that of a sex- and age-matched control
group with no major medical problems. Methods We prospectively perfor
med overnight polysomnography in 24 patients with a recent stroke (13
men and 11 women; mean age [+/-SD], 64.6+/-10.4 years) and 27 subjects
without stroke (13 men and 14 women; mean age, 61.6+/-8.8 years). Pat
ients with either ischemic or hemorrhagic stroke were entered into thi
s study. Polysomnographic evaluations were performed within approximat
ely 2 to 5 weeks after each patient's stroke. Results Obstructive slee
p apnea was found in 10 of 13 men with stroke (77%) and in only 3 of 1
3 male subjects without stroke (23%) (P=.0169). Seven of 11 women with
stroke (64%) had obstructive sleep apnea, while only 2 of 14 female s
ubjects without stroke (14%) had obstructive sleep apnea (P=.0168). Fo
r men with stroke, the mean apnea/hypopnea index (+/-SE) was 21.5+/-4.
2 events per hour, while for male subjects without stroke it was 4.8+/
-1.8 events per hour (P=.0014). For women with stroke the mean apnea/h
ypopnea index was 31.6+/-8.8 events per hour, while for female subject
s without stroke it was 2.9+/-1.6 events per hour (P=.0024). The 4-yea
r mortality for patients with stroke was 20.8%. All patients with stro
ke who died had obstructive sleep apnea. Conclusions Patients with str
oke have an increased incidence of obstructive sleep apnea compared wi
th normal sex- and age-matched control subjects. Hypoxia and hemodynam
ic responses to obstructive sleep apnea may have predisposed these pat
ients to stroke.