title: Lack of repercussions of sleep apnea syndrome on recovery and attention disorders at the subacute stage after stroke: a study of 45 patients.
abstract: BACKGROUND
  Sleep apnea syndrome (SAS) frequently occurs after a stroke. Its association with a poor prognosis is open to discussion.
  
  
  OBJECTIVE
  To study, in a physical and rehabilitation medicine (PRM) unit, the possible repercussions of SAS on neurological and functional recovery as well as attentional abilities following a stroke.
  
  
  METHODS
  Forty-five patients, all of whom had recently had a stroke without previously documented SAS, were screened using the ApneaLink(®) system. An apnea-hypopnea index (AHI) score ≥10 was considered as indicative of SAS. The NIHSS, Fugl-Meyer (FM) and Functional Independence Measure (FIM) Scales were applied on admission and at two months as means of assessing neurological and functional recovery, which was expressed by the difference between the first and the second scores (delta FM, delta NIHSS, delta FIM). The Battery Attention William Lennox (BAWL) Test was given once in order to evaluate attention disorders. SAS severity was categorized according to the AHI. We compared the groups formed (mild, moderate and severe) using the same method.
  
  
  RESULTS
  Twenty-eight patients (62.2%) presented AHI ≥ 10. Stroke characteristics were comparable in the SAS+ and the SAS- groups, with average post-stroke time lapse of 26 days, initial average FIM score of 71.2 points ± 26.3 and initial average NIHSS score of 8.9 ± 4.9. The demographic characteristics of the two groups were likewise comparable with the exception of age, as the SAS+ group was pronouncedly older (65.4 vs. 53.5 years). As for delta FIM, which evaluated functional recovery, it averaged 31.8 ± 20.6. Cases of SAS were found to be mild (37.1%), moderate (28.6%) or severe (34.3%). No significant difference was observed on admission or at 2 months as regards the clinical scales or the BAWL test between the two groups or according to severity, except for the NIHSS score at 2 months in the severe sub-group.
  
  
  CONCLUSIONS
  This study did not demonstrate the supposed repercussions of SAS on the recovery or attentional abilities of post-stroke patients. The tests were maybe given too early; they should take place at a lengthier time interval after the stroke, and also to be more complete.
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France. Electronic address: clemence75@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Lefèvre-Dognin
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Stana
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Jousse
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Lucas
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Sportouch
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Bradai
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Guettard
authors.affiliation: Unité de recherche clinique, université Paris-Diderot, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Vicaut
authors.affiliation: Service de MPR, université Paris-Diderot, UMR 8194, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, 200, rue Faubourg-St-Denis, 75010 Paris, France.
authors.forename: A P
authors.initials: AP
authors.lastname: Yelnik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020127:Recovery of Function; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000523:psychology*; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D013997:Time Factors
keywords: Accident vasculaire cérébral; Apnea syndrome; Apnée du sommeil; Attention disorders; Functional recovery; Récupération fonctionnelle; Stroke; Troubles attentionnels