Clinical Characteristics of Sleep-Disordered Breathing in Subacute Phase of Stroke

OBJECTIVE To assess the frequency and severity of sleep-disordered breathing (SDB) in subacute stroke patients in Korea. METHODS We consecutively enrolled subacute stroke patients who were transferred to the Department of Rehabilitation Medicine from February 2016 to August 2016. The inclusion criteria were as follows: diagnosis of the first onset of cerebral infarction or hemorrhage in the brain by computed tomography or magnetic resonance imaging; patients between 18 and 80 years old; and patients admitted within 7 days to 6 months after stroke onset. We evaluated baseline clinical data on patients' admission to the Department of Rehabilitation Medicine. We assessed demographic data, stroke severity, neurologic impairment, cognition and quality of life. We used the Epworth Sleepiness Scale to assess quality of sleep. We used a portable polysomnography to detect SDB. RESULTS Of the 194 stroke patients, 76 patients enrolled in this study. We evaluated and included 46 patients in the outcome analysis. The mean apnea-hypopnea index (AHI) was 24.2±17.0 and 31 patients (67.4%) exhibited an AHI ≥15. Those in the SDB group showed a higher National Institutes of Health Stroke Scale, lower Functional Ambulation Category, lower Korean version of Modified Barthel Index, and lower EuroQol five dimensions questionnaire (EQ-5D) at admission. Prevalence and clinical characteristics of SDB did not show significant differences among stroke types or locations. CONCLUSION SDB is common in subacute stroke patients. SDB must be evaluated after a stroke, particularly in patients presenting severe neurologic impairment.