INTRODUCTION STROKE IS A COMMON DEBILITATING CONDITION IN THE OLDER POPULATION AND ACCOUNTS FOR A LARGE NUMBER OF ACUTE HOSPITAL ADMISSIONS. Chronic functional and mental disabilities

STROKE IS A COMMON DEBILITATING CONDITION IN THE OLDER POPULATION AND ACCOUNTS FOR A LARGE NUMBER OF ACUTE HOSPITAL ADMISSIONS. Chronic functional and mental disabilities are frequent sequelae of stroke, preventing patients with stroke from returning home. Because of this, patients with stroke are often hospitalized for prolonged periods in acute care hospitals and frequently must undergo further lengthy hospitalization in a stroke rehabilitation unit (SRU). Thus not only is stroke a serious medical condition, it is also a great financial burden on patients, their families, and the healthcare system. Unfortunately, medically, there is often very little that can be done to reverse the underlying condition. Thus, it would be important to identify any coexisting, potentially reversible, condition that could impair recovery from stroke. One such condition could be sleep apnea (SA). Recent evidence indicates that SA, especially obstructive sleep apnea (OSA), is very common among patients with stroke.1-6 A large population-based study also showed that OSA may be an independent risk factor for stroke.7 Moreover, there is evidence to suggest that the presence of SA in patients with stroke is associated with poor functional status and high mortality.1,2 OSA could predispose to stroke through its association with hypertension and increased platelet aggregability and blood coagulability.8-14 Once a stroke has occurred, SA could aggravate functional and mental disabilities because of recurrent nocturnal hypoxia and fragmentation of sleep, as well as reduced cardiac output and cerebral perfusion.15-18 If so, SA in patients with stroke may contribute to prolonged poststroke hospitalization and rehabilitation. However, there have been no studies examining the potential influence of SA on length of hospitalization following stroke. We therefore hypothesized that, in patients with stroke undergoing rehabilitation, the presence of SA will be associated with a greater degree of functional impairment and a consequent longer hospitalization than in patients with stroke but without SA.