Ann Rehabil Med.  2017 Aug;41(4):556-563. 10.5535/arm.2017.41.4.556.

Clinical Characteristics of Sleep-Disordered Breathing in Subacute Phase of Stroke

Affiliations
  • 1Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea. drjeesungju@hanmail.net

Abstract


OBJECTIVE
To assess the frequency and severity of sleep-disordered breathing (SDB) in subacute stroke patients in Korea.
METHODS
We consecutively enrolled subacute stroke patients who were transferred to the Department of Rehabilitation Medicine from February 2016 to August 2016. The inclusion criteria were as follows: diagnosis of the first onset of cerebral infarction or hemorrhage in the brain by computed tomography or magnetic resonance imaging; patients between 18 and 80 years old; and patients admitted within 7 days to 6 months after stroke onset. We evaluated baseline clinical data on patients' admission to the Department of Rehabilitation Medicine. We assessed demographic data, stroke severity, neurologic impairment, cognition and quality of life. We used the Epworth Sleepiness Scale to assess quality of sleep. We used a portable polysomnography to detect SDB.
RESULTS
Of the 194 stroke patients, 76 patients enrolled in this study. We evaluated and included 46 patients in the outcome analysis. The mean apnea-hypopnea index (AHI) was 24.2±17.0 and 31 patients (67.4%) exhibited an AHI ≥15. Those in the SDB group showed a higher National Institutes of Health Stroke Scale, lower Functional Ambulation Category, lower Korean version of Modified Barthel Index, and lower EuroQol five dimensions questionnaire (EQ-5D) at admission. Prevalence and clinical characteristics of SDB did not show significant differences among stroke types or locations.
CONCLUSION
SDB is common in subacute stroke patients. SDB must be evaluated after a stroke, particularly in patients presenting severe neurologic impairment.

Keyword

Rehabilitation; Sleep; Sleep apnea syndromes; Stroke

MeSH Terms

Brain
Cerebral Infarction
Cognition
Diagnosis
Hemorrhage
Humans
Korea
Magnetic Resonance Imaging
National Institutes of Health (U.S.)
Polysomnography
Prevalence
Quality of Life
Rehabilitation
Sleep Apnea Syndromes*
Stroke*
Walking

Figure

  • Fig. 1 CONSORT diagram for patient inclusion and exclusion.


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