Dysphagia and Obstructive Sleep Apnea in Acute, First-Ever, Ischemic Stroke

Losurdo, Anna; Brunetti, Valerio; Broccolini, Aldobrando; Caliandro, Pietro; Frisullo, Giovanni; Morosetti, Roberta; Pilato, Fabio; Profice, Paolo; Giannantoni, Nadia Mariagrazia; Sacchetti, Maria Luisa; Testani, Elisa; Vollono, Catello; Marca, Giacomo Della

doi:10.1016/j.jstrokecerebrovasdis.2017.09.051

Cited by 14 publications

(29 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…findings of this study support this notion by showing that dysphagia severity, along with being male, having greater functional disability and having an increased BMI, can independently predict OSA severity following acute stroke. This is the strongest evidence to date of such a relationship, as previous studies examining possible relationships between SDB severity and dysphagia severity in acute stroke (Losurdo et al, 2018;Shibazaki et al, 2014) have not used the OAHI as the outcome measure, and therefore have not been able to separately consider the obstructive and the central components of SDB.…”

Section: Discussionmentioning

confidence: 95%

“…Obstructive sleep apnea was common in the participants of this study, occurring in 85% of our cohort. Given that stroke-induced impairment of pharyngeal muscle function is common to dysphagia and OSA, it is likely that the two conditions share a similar underlying mechanism (Losurdo et al, 2018;Shibazaki et al, 2014 The effect size was measured by the partial eta-square statement of PROC GLM.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only a handful of studies have examined the relationship between SDB and dysphagia in acute stroke (Broadley et al, 2007;Brown et al, 2010;Losurdo et al, 2018;Martínez-García, Galiano-Blancart, Soler-Cataluña, Cabero-Salt, & Román-Sánchez, 2006;Shibazaki et al, 2014;Turkington et al, 2002). For example, Losurdo et al showed that OSA (defined as an AHI ≥ 10 events/hr) was independently associated with dysphagia, older age and higher body mass index (BMI) and neck circumference in patients with acute ischaemic stroke (Losurdo et al, 2018). Shibazaki et al found in Japanese patients with intracerebral haemorrhage that dysphagia plus dysarthria was independently associated with severe SDB (defined as a respiratory disturbance index of ≥30 events/hr) (Shibazaki et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, Brown et al demonstrated that dysphagia was not independently associated with OSA (defined as an AHI ≥ 5 events/hr) following acute ischaemic stroke (Brown et al, 2010). There are several potential reasons for these inconsistent findings, including the absence of full polysomnography (PSG) to assess sleep, use of variable guidelines when recording and analysing PSG data, and use of different measures of dysphagia severity (Brown et al, 2010;Losurdo et al, 2018;Shibazaki et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sleep‐disordered breathing in patients with stroke‐induced dysphagia

Estai

Walsh

Maddison

et al. 2020

Journal of Sleep Research

View full text Add to dashboard Cite

This study examined the nature and characteristics of sleep-disordered breathing, including obstructive sleep apnea and central sleep apnea, in patients with post-stroke dysphagia, to determine the demographic, anthropometric and clinical variables that were associated with sleep-disordered breathing. Thirty-nine patients diagnosed with acute stroke (28 males and 11 females with a mean age of 72.3 ± 10.0 years) underwent overnight polysomnography (within 3.9 ± 1.6 days after admission). Sleep-disordered breathing was described by the apnea-hypopnea index and its obstructive and central components by the obstructive apnea-hypopnea index and central apnea-hypopnea index, respectively. Severity of dysphagia was assessed using the Mann Assessment of Swallowing Ability score. Severity of stroke and functional dependence were assessed by the National Institute of Health Stroke Scale and the modified Barthel index, respectively. Most of the cohort (87%) had moderate-to-severe dysphagia (Mann Assessment of Swallowing Ability of 143.2 ± 19.9). Sleep-disordered breathing (apnea-hypopnea index ≥ 5 events/hr) was present in 38 participants (97%) with a mean apnea-hypopnea index of 37.5 ± 24.4 events/hr. Sleep-disordered breathing was predominantly obstructive in nature, with a mean obstructive apnea-hypopnea index and central apnea-hypopnea index of 19.6 ± 15.7 and 11.4 ± 17.6 events/hr, respectively. Multivariate linear regression analyses showed that the apnea-hypopnea index was associated with sex (p = .0001), body mass index (p = .029) and the modified Barthel index (p = .006); the obstructive apnea-hypopnea index was associated with the Mann Assessment of Swallowing Ability (p = .006), sex (p = .004) and body mass index (p = .015) and had a nonlinear relationship with the modified Barthel index (p = .019); and the central apnea-hypopnea index was associated with sex (p = .027) and the modified Barthel index (p = .019). The present study showed that dysphagia severity was associated with obstructive sleep apnea severity and this association was independent of sex, modified Barthel index and body mass index.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sleep‐disordered breathing in patients with stroke‐induced dysphagia

Estai

Walsh

Maddison

et al. 2020

Journal of Sleep Research

View full text Add to dashboard Cite

show abstract

“…Lack of oxygen increases the risk of stroke. For instance, the prolonged hypoxia of obstructive sleep apnea hypopnea syndrome can damage the sleep structure, increase blood pressure, reduce cerebral blood flow and promote microthrombosis and atherosclerosis, thus impacting the prognosis and recurrence of cerebral infarction [ 66 , 67 ]. Mao et al reported that six COVID-19 patients had acute cerebrovascular disease: five with severe infections (5/88) and one with a non-severe infection (1/126) (P=0.03) [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Neurological manifestations in COVID-19 and its possible mechanism

Tang

Luo

Song

et al. 2020

Aging

View full text Add to dashboard Cite

In December 2019, the first cases of the acute respiratory illness now known as Corona Virus Disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China. The main clinical manifestations of COVID-19 are a fever, dry cough and general weakness, although in some patients, a headache, tight chest, diarrhea, etc. are the first clinical manifestations. Neurological practice is involved in all aspects of medicine, from primary care for patients with migraines to consultations with patients in the intensive care unit. Few disorders spare the nervous system, and newly emerging infections are no exception. As neurologists, we are concerned about the effects of SARS-CoV-2 infections on the nervous system. Multiple neuropathy, rhabdomyolysis, cerebrovascular disease, central nervous system infections and other common neurological diseases require attention during this outbreak.

show abstract

Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship

Brunetti

Rollo

Broccolini

et al. 2022

Curr Neurol Neurosci Rep

Self Cite

View full text Add to dashboard Cite

Purpose of Review To elucidate the interconnection between sleep and stroke. Recent Findings Growing data support a bidirectional relationship between stroke and sleep. In particular, there is strong evidence that sleep-disordered breathing plays a pivotal role as risk factor and concur to worsening functional outcome. Conversely, for others sleep disorders (e.g., insomnia, restless legs syndrome, periodic limb movements of sleep, REM sleep behavior disorder), the evidence is weak. Moreover, sleep disturbances are highly prevalent also in chronic stroke and concur to worsening quality of life of patients. Promising novel technologies will probably allow, in a near future, to guarantee a screening of commonest sleep disturbances in a larger proportion of patients with stroke. Summary Sleep assessment and management should enter in the routinary evaluation of stroke patients, of both acute and chronic phase. Future research should focus on the efficacy of specific sleep intervention as a therapeutic option for stroke patients.

show abstract

Dysphagia and Obstructive Sleep Apnea in Acute, First-Ever, Ischemic Stroke

Cited by 14 publications

References 37 publications

Sleep‐disordered breathing in patients with stroke‐induced dysphagia

Sleep‐disordered breathing in patients with stroke‐induced dysphagia

Neurological manifestations in COVID-19 and its possible mechanism

Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship

Contact Info

Product

Resources

About