INVESTIGATING THE RELATIONSHIP BETWEEN STROKE AND OBSTRUCTIVE SLEEP-APNEA

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.