Signs and Symptoms of Sleep Apnea and Acute Stroke Severity

Is Sleep Apnea Neuroprotective?

Sebastian Koch, Sylvia Zuniga, Alejandro A. Rabinstein, Jose G Romano, Bruce Nolan, Julio Chirinos, Alejandro Forteza

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: In animal models, brief periods of hypoxemia render the brain tolerant to subsequent ischemic insults. Sleep apnea leads to frequent episodes of nocturnal hypoxemia and may induce ischemic tolerance. Snoring and daytime sleepiness are cardinal symptoms of sleep apnea. We undertook this study to determine differences in stroke severity and early neurologic course in patients at risk for sleep apnea as determined by a sleep questionnaire. Methods: Patients admitted with acute ischemic stroke completed the Berlin questionnaire. The Berlin questionnaire examines habitual snoring, daytime sleepiness, presence of hypertension, and body mass index (BMI) and classifies patients into a high or low risk for sleep apnea group. National Institutes of Health Stroke Scale (NIHSS) score was determined on admission and day 5 of hospitalization. Age, sex, cardiovascular risk factors, BMI, and stroke mechanism were determined prospectively. Results: We enrolled 190 patients with a mean age of 60 years and 53% were men. The Berlin questionnaire classified 103 patients (54%) at high risk for sleep apnea. The median NIHSS score on admission and day 5 of hospitalization did not differ between the two groups after multivariate analysis. Examined separately, we found no effect of snoring, daytime sleepiness, or BMI on acute stroke severity and outcome. Conclusion: We found that a large number of patients admitted with acute ischemic stroke were at high risk for having sleep apnea. We were not able to show that a constellation of symptoms and features highly suggestive of sleep apnea influenced stroke severity or early neurologic course after acute ischemic stroke.

Original languageEnglish
Pages (from-to)114-118
Number of pages5
JournalJournal of Stroke and Cerebrovascular Diseases
Volume16
Issue number3
DOIs
StatePublished - May 1 2007

Fingerprint

Sleep Apnea Syndromes
Signs and Symptoms
Stroke
Snoring
Berlin
Body Mass Index
National Institutes of Health (U.S.)
Nervous System
Hospitalization
Sleep
Multivariate Analysis
Animal Models
Hypertension
Surveys and Questionnaires
Brain

Keywords

  • Acute stroke
  • neuroprotection
  • sleep apnea

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Health Professions(all)

Cite this

Signs and Symptoms of Sleep Apnea and Acute Stroke Severity : Is Sleep Apnea Neuroprotective? / Koch, Sebastian; Zuniga, Sylvia; Rabinstein, Alejandro A.; Romano, Jose G; Nolan, Bruce; Chirinos, Julio; Forteza, Alejandro.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 16, No. 3, 01.05.2007, p. 114-118.

Research output: Contribution to journalArticle

Koch, Sebastian ; Zuniga, Sylvia ; Rabinstein, Alejandro A. ; Romano, Jose G ; Nolan, Bruce ; Chirinos, Julio ; Forteza, Alejandro. / Signs and Symptoms of Sleep Apnea and Acute Stroke Severity : Is Sleep Apnea Neuroprotective?. In: Journal of Stroke and Cerebrovascular Diseases. 2007 ; Vol. 16, No. 3. pp. 114-118.
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