title: Polysomnographic indicators of mortality in stroke patients.
abstract: OBJECTIVE
  The purpose of the study was to assess polysomnographic indicators of increased mortality risk in patients with stroke or a transient ischemic attack (TIA).
  
  
  METHODS
  We performed polysomnographies in 63 acute stroke/TIA patients. Mortality data were collected from a national database after a 19-37-month follow-up period.
  
  
  RESULTS
  Of the 57 stroke and 6 TIA patients, 9 stroke patients died during follow-up. All nine had moderate or severe sleep-related breathing disorders (SRBDs). Binarily divided, the group with the highest apnea hypopnea index (AHI) had an almost 10-fold higher mortality risk (hazard ratio (HR) 9.71; 95 % confidence interval (CI) 1.20-78.29; p = 0.033) compared to the patients with the lowest AHI. The patients with the longest versus shortest nocturnal wake time had a higher mortality (HR 8.78; 95 % CI 1.1-71.8; p = 0.0428). Lung disease increased mortality (HR 9.92; 95 % CI 2.00-49.23; p = 0.005), and there was a trend toward a higher mortality risk with atrial fibrillation/flutter (HR 3.63; 95 % CI 0.97-13.51; p = 0.055).
  
  
  CONCLUSIONS
  In stroke patients, the AHI and nocturnal wake time are indicators of increased mortality risk. SRBDs in stroke patients should receive increased attention.
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet - Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, DK-2600, Glostrup, Denmark. laura_ponsaing@hotmail.com.|Center for Healthy Aging, Copenhagen University, Blegdamsvej 3b, DK-2200, Copenhagen N, Denmark. laura_ponsaing@hotmail.com.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Ponsaing
authors.affiliation: The Stroke Unit, Department of Neurology, Rigshospitalet - Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, DK-2600, Glostrup, Denmark.
authors.forename: Helle K
authors.initials: HK
authors.lastname: Iversen
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet - Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, DK-2600, Glostrup, Denmark.|Center for Healthy Aging, Copenhagen University, Blegdamsvej 3b, DK-2200, Copenhagen N, Denmark.
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality; D001282:Atrial Flutter / Q000175:diagnosis / Q000401:mortality; D015897:Comorbidity; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008171:Lung Diseases / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D016016:Proportional Hazards Models; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000401:mortality*; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality*; D015996:Survival Rate; D014851:Wakefulness
keywords: Mortality; Polysomnography; Sleep-related breathing disorders; Stroke; Transient ischemic attack; Wake time