title: Ischemic stroke subtype and presence of sleep-disordered breathing: the BASIC sleep apnea study.
abstract: BACKGROUND
  Little is known about the prevalence of sleep-disordered breathing (SDB) across ischemic stroke subtypes. Given the important implications for SDB screening, we tested the association between SDB and ischemic stroke subtype in a population-based study.
  
  
  METHODS
  Within the Brain Attack Surveillance in Corpus Christi Project, ischemic stroke patients were offered SDB screening with the ApneaLink Plus (n = 355). A neurologist assigned Trial of the ORG 10172 in Acute Stroke Treatment subtype (with an additional category for nonlacunar infarctions of unknown etiology) using hospital records. Unadjusted and adjusted (demographics, body mass index, National Institutes of Health Stroke Scale, diabetes, history of stroke/transient ischemic attack) logistic and linear regression models were used to test the association between subtype and SDB or apnea-hypopnea index (AHI).
  
  
  RESULTS
  Median age was 65%, and 55% were men; 59% were Mexican American. Median time from stroke onset to SDB screen was 13 days (interquartile range [IQR] 6, 21). Overall, 215 (61%) had SDB (AHI ≥ 10). Median AHI was 13 (IQR 6, 27). Prevalence of SDB by subtype was cardioembolism, 66%; large-artery atherosclerosis, 57%; small-vessel occlusion, 68%; other determined, 50%; undetermined etiology, 58%; and nonlacunar stroke of unknown etiology, 63%. Ischemic stroke subtype was not associated with SDB in unadjusted (P = .72) or adjusted models (P = .91) models. Ischemic stroke subtype was not associated with AHI in unadjusted (P = .41) or adjusted models (P = .62).
  
  
  CONCLUSIONS
  In this population-based stroke surveillance study, ischemic stroke subtype was not associated with the presence or severity of SDB. Sleep-disordered breathing is likely to be present after ischemic stroke, and the subtype should not influence decisions about SDB screening.
authors.affiliation: Stroke Program, University of Michigan, Ann Arbor, Michigan. Electronic address: devinb@umich.edu.
authors.forename: Devin L
authors.initials: DL
authors.lastname: Brown
authors.affiliation: Department of Neurology, University at Buffalo, The State University of New York, Buffalo, New York.
authors.forename: Ashkan
authors.initials: A
authors.lastname: Mowla
authors.affiliation: Stroke Program, University of Michigan, Ann Arbor, Michigan.
authors.forename: Mollie
authors.initials: M
authors.lastname: McDermott
authors.affiliation: Stroke Program, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: Lewis B
authors.initials: LB
authors.lastname: Morgenstern
authors.affiliation: Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Garnett
authors.initials: G
authors.lastname: Hegeman
authors.affiliation: Stroke Program, University of Michigan, Ann Arbor, Michigan.
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Smith
authors.affiliation: Stroke Program, University of Michigan, Ann Arbor, Michigan.
authors.forename: Nelda M
authors.initials: NM
authors.lastname: Garcia
authors.affiliation: Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Chervin
authors.affiliation: Stroke Program, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: Lynda D
authors.initials: LD
authors.lastname: Lisabeth
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002545:Brain Ischemia / Q000145:classification / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000503:physiopathology; D020521:Stroke / Q000145:classification / Q000150:complications* / Q000503:physiopathology
keywords: Ischemic stroke; epidemiology; sleep apnea; sleep-disordered breathing; stroke subtype