Prevalence of sleep-disordered breathing in acute ischemic stroke as determined using a portable sleep apnea monitoring device in Korean subjects.
OBJECTIVE
It has been suggested that there is a strong association between sleep-disordered breathing (SDB) and stroke. However, this connection has not been studied in Korean subjects.


METHODS
Sixty-one patients with acute cerebral infarction (ACI) and 13 patients with transient ischemic attack (TIA) were consecutively enrolled. SDB was evaluated within 48 h of stroke or TIA onset using a portable screening device, which allowed incidents of apnea, hypopnea, and snoring to be automatically analyzed. Clinical and sleep-related variables, including body mass indices (BMI), cardiovascular risk factors, stroke severity and disability, and Epworth sleepiness scale, Stanford sleepiness scale, and Berlin questionnaire scores were assessed. Sixty-four age-matched patient's spouses or family members with no history of physician-diagnosed stroke were enrolled as controls.


RESULTS
Mean apnea-hypopnea index (AHI) was significantly higher in TIA (14.6 ± 10.4) and ACI (15.6 ± 14.7) patients than in the controls (7.8 ± 7.0; p = 0.001). The prevalences of SDB were 69.2% in TIA and 50.8% in ACI patients and 32.8% in controls. BMI and systolic blood pressure (SBP) were significantly higher in patients with SDB than in patients without SDB. Sleep-related stroke onset occurred in 17 patients (22.9%), and these patients had significantly higher AHIs. Multiple logistic regression analysis showed that BMI (odds ratio, 1.293; p = 0.027) and SBP (odds ratio, 1.030; p = 0.004) were found to independently predict SDB in patients with TIA or ACI.


CONCLUSIONS
SDB is prevalent during the 48 h following ACI or TIA in Korean subjects. The authors recommend that SDB be evaluated after an ACI or TIA, especially in those with a high BMI and an elevated SBP.
Joo
Byung-Euk
BE
Department of Neurology, Korea University Medical Center, Korea University College of Medicine, #126-1, Anam-Dong 5Ga, Seongbuk-Gu, Seoul, 136-705, South Korea.
Seok
Hung Youl
HY
Yu
Sung-Wook
SW
Kim
Byung-Jo
BJ
Park
Kun-Woo
KW
Lee
Dae-Hie
DH
Jung
Ki-Young
KY
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D001794:Blood Pressure; D015992:Body Mass Index; D002544:Cerebral Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D017286:Polysomnography / Q000295:instrumentation*; D012044:Regression Analysis; D056910:Republic of Korea; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology*; D013223:Statistics as Topic