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Kushida, C.A., Littner, M.R., Morgenthaler, T., Alessi, C.A., Bailey, D., Coleman, J., Friedman, L., Hirshkowitz, M., Kapen, S., Kramer, M., Lee-Chiong, T., Loube, D.L., Owens, J., Pancer, J.P. and Wise, M. (2005) Practice parameters for the indications for polysomnography and re-lated procedures: An update for 2005. Sleep, 28, 499-521.

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• TITLE: MRI and polysomnographic findings of patients affected by post-stroke sleep apnea

  AUTHORS: Maria Luisa Sacchetti, Maria Teresa Di Mascio, Marco Fiorelli, Giacomo Della Marca, Anna Losurdo, Gennaro Russo, Danilo Toni, Antonio Minni, Emanuele Tinelli, Francesca Caramia

  KEYWORDS: Sleep Apnea-Stroke; Magnetic Risonance Imaging-Polysomnography

  JOURNAL NAME: Health, Vol.5 No.8B, August 14, 2013

  ABSTRACT: Aim: The aim of our study was to compare characteristics of stroke patients who presented Obstructive Sleep Apnea/Hypopnea (OSAH) to those of cases that presented Central Sleep Apnea/Hypopnea (CSAH) events at PSG, and to investigate relationships between the type of breathing disturb during sleep and the location of brain damage. Methods: Thirty four patients were submitted to clinical, neuroradiological and polisomnographyc study (PSG) after 4 months of stroke. A Sleep Disordered Breathing (SDB) was diagnosed in all cases with an AHI > 5. Patients were classified as affected by predominantly OSAH (pOSAH), or predominantly CSAH (pCSAH). Comparisons were made among the groups and correlation analyses were done in each group. Significance was set at p pOSAH. Except for age, no statistical differences were found between the two groups as to clinical findings, risk factors for stroke, PSG data, or location of brain lesion. Correlation analysis outlined that in pOSAH cases the time interval from stroke to PSG (Δt) was inversely related to both TST (p = 0.017) and TSP (p = 0.039); in pCSAHs it was inversely related to SE Index (p = 0.021) and directly related to both ODI (p = 0.016) and with the n. of arrhythmias/h sleep (p = 0.033). In pCSAH, AHI did not correlate with ODI. Conclusions: Our data suggest that among cases with post stroke SDB is included 3 different subgroups of cases: OSAHs who terminate the obstruction by arousal, OSAHs who do not arise and alternate obstructive to central events, and CSAHs due to the direct effect of stroke on the breathing network; in a forth subgroup of cases， the microstructure of sleep might be altered, with the consequent occurrence of sleep-related events. Further studies are needed to clarify these hypotheses as well as the role of poststroke depression on the nature and occurrence of SDB after stroke.