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.