Sleep-disordered breathing severity remained stable in the year after stroke (P=0.35 for respiratory event index), though the obstructive apnea index increased over time (P<0.01).
Cohort (n=414)
Does sleep-disordered breathing severity change over the first year following a first-ever ischemic stroke?
Sleep-disordered breathing severity remains significant and stable in the year following an ischemic stroke, challenging previous reports of diminishing severity and supporting early assessment and treatment.
valor p: p=0.35
BACKGROUND: The aim of this study was to characterize change in sleep-disordered breathing severity in the year following stroke, overall, and by ethnicity, within the population-based Brain Attack Surveillance in Corpus Christi Project. METHODS: First-ever ischemic strokes (n=414) were ascertained by active and passive surveillance and validated by stroke-trained physicians. Patients with stroke were invited to participate in portable sleep apnea testing (ApneaLink Plus) at baseline and 3, 6, and 12 months poststroke. Sleep-disordered breathing severity was assessed by the respiratory event index (apneas and hypopneas/hour of recording). The component obstructive apnea index and central apnea index were also assessed. Time and ethnicity effects on outcomes, as well as ethnic differences in time effects, were analyzed using generalized estimating equations with multivariable adjustment for confounding factors. RESULTS: Mean age (n=414) was 63.9 years (SD=10.9); 68.4% were Mexican American. Baseline mean respiratory event index, obstructive apnea index, and central apnea index were 21.3 (SD=16.6), 8.6 (SD=11.5), and 1.5 (SD=3.2), respectively. There was no time effect on respiratory event index ( P =0.35) but obstructive apnea index increased over time ( P <0.01). Averaged over follow-up, respiratory event index and obstructive apnea index were significantly higher in Mexican American than non-Hispanic White persons. No ethnic difference in the time effect was found for either outcome. For central apnea index, there was an ethnicity-time interaction ( P =0.01) such that central apnea index increased in non-Hispanic White but did not change in Mexican American persons. CONCLUSIONS: Sleep-disordered breathing severity was significant and stable for most individuals in the year after stroke. These results do not confirm previous reports of diminishing sleep-disordered breathing severity over time after stroke and would support early assessment and treatment where indicated.
Lisabeth et al. (Mon,) conducted a cohort in First-ever ischemic stroke (n=414). Sleep-disordered breathing assessment was evaluated on Change in respiratory event index over time (p=0.35). Sleep-disordered breathing severity remained stable in the year after stroke (P=0.35 for respiratory event index), though the obstructive apnea index increased over time (P<0.01).