Sleep-disordered breathing among patients with first-ever stroke

Sleep-disordered breathing (SDB) in the form of obstructive sleep apnea is a possible risk factor for stroke. We carried out a cross-sectional survey out in a rehabilitation center among patients with first-ever stroke to fur ther determine the incidence and types of SDB and its relationship to known risk factors for stroke. Full polysomnography was performed in 147 consecu tive patients (95 men, 52 women, age 61 +/- 10 years) admitted to our neuro logical Rehabilitation Department 46 +/- 20 days after first-ever stroke. S ubjective sleepiness (Epworth Sleepiness Scale), vascular risk factors, ant hropometric data, and polysomnographic findings were compared between strok e patients with varying degrees of SDB. With a cutoff point for the respira tory disturbance index (RDI) of 5, 10, 15, or 20 the respective prevalence of SDB was 61%, 44%, 32%, and 22%. The type of SDB was generally obstructiv e, with dominant central apneas in only 6% of patients. Patients with an RD I of 20 or higher had less REM sleep, thicker necks, and a more central typ e of obesity. Even in patients with an RDI of 20 or higher subjective sleep iness, although higher than in those without SDB, was not a predominant sym ptom. Snoring and anthropometric data suggest that obstructive SDB may have existed prior to stroke. The prevalence of hypertension and coronary heart disease were higher among stroke patients with an RDI of 20 or higher than in those without SDB. We conclude that the prevalence of SDB among patient s with stroke is high. Examination of stroke should include screening for S DB.