title: Obstructive Sleep Apnea is Related to Impaired Cognitive and Functional Status after Stroke.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is a common sleep disorder in stroke patients and is associated with prolonged hospitalization, decreased functional outcome, and recurrent stroke. Research on the effect of OSA on cognitive functioning following stroke is scarce. The primary objective of this study was to compare stroke patients with and without OSA on cognitive and functional status upon admission to inpatient rehabilitation.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  147 stroke patients admitted to a neurorehabilitation unit.
  
  
  METHODS
  N/A.
  
  
  METHODS
  All patients underwent sleep examination for diagnosis of OSA. We assessed cognitive status by neuropsychological examination and functional status by two neurological scales and a measure of functional independence.
  
  
  RESULTS
  We included 80 stroke patients with OSA and 67 stroke patients without OSA. OSA patients were older and had a higher body mass index than patients without OSA. OSA patients performed worse on tests of attention, executive functioning, visuoperception, psychomotor ability, and intelligence than those without OSA. No differences were found for vigilance, memory, and language. OSA patients had a worse neurological status, lower functional independence scores, and a longer period of hospitalization in the neurorehabilitation unit than the patients without OSA. OSA status was not associated with stroke type or classification.
  
  
  CONCLUSIONS
  Obstructive sleep apnea (OSA) is associated with a lower cognitive and functional status in patients admitted for stroke rehabilitation. This underlines the importance of OSA as a probable prognostic factor, and calls for well-designed randomized controlled trials to study its treatability.
authors: Heliomare Research and Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands.|Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands.
authors: Justine A
authors: JA
authors: Aaronson
authors: Heliomare Research and Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands.
authors: Coen A M
authors: CA
authors: van Bennekom
authors: Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands.
authors: Winni F
authors: WF
authors: Hofman
authors: Heliomare Research and Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands.
authors: Tijs
authors: T
authors: van Bezeij
authors: Department of Pulmonary Medicine, Medical Center Alkmaar, Alkmaar, Netherlands.
authors: Joost G
authors: JG
authors: van den Aardweg
authors: Heliomare Research and Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands.
authors: Erny
authors: E
authors: Groet
authors: Heliomare Research and Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands.
authors: Wytske A
authors: WA
authors: Kylstra
authors: Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands.|Department of Neurology, Academic Medical Center, Amsterdam, Netherlands.
authors: Ben
authors: B
authors: Schmand
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications* / Q000209:etiology / Q000503:physiopathology*; D056344:Executive Function; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007360:Intelligence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011597:Psychomotor Performance; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D020521:Stroke / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D055815:Young Adult
keywords: cognition; functional status; obstructive sleep apnea; rehabilitation; stroke