Obstructive Sleep Apnea Is a Risk Factor for Death in Patients With Stroke

Sahlin, Carin; Sandberg, Olov; Gustafson, Yngve; Bucht, Gösta; Carlberg, Bo; Stenlund, Hans; Franklin, Karl A.

doi:10.1001/archinternmed.2007.70

Cited by 306 publications

(207 citation statements)

References 26 publications

Supporting

Mentioning

185

Contrasting

Unclassified

Order By: Relevance

“…Only patients with OSA (AHI >10) had an increased risk of early death. 9 In a prospective study on 161 patients admitted to a stroke unit, no relationships were found between sleep-related respiratory events and the topographic location of the neurologic lesion or vascular involvement. 34 …”

Section: Prevalence Of Obstructive Sleep Apnea In the Poststroke Periodmentioning

confidence: 97%

“…[31][32][33][34][35] The reported prevalence in the literature is very high, ranging from 40% to 90%, 9,10,34,[36][37][38][39][40] likely reflecting different study designs and definitions of SDB.…”

Section: Prevalence Of Obstructive Sleep Apnea In the Poststroke Periodmentioning

confidence: 99%

“…10 However, only OSA is recognized as a mortality risk for ischemic stroke. 9,48,49 Periodic breathing (PB) may also develop in patients with stroke in the absence of cardiopulmonary disease, disturbed consciousness, or HF. 50 During the acute phase of stroke, obstructive apnea is the most predominant type.…”

Section: Prevalence Of Obstructive Sleep Apnea In the Poststroke Periodmentioning

confidence: 99%

“…28 In contrast, the presence of OSA in the setting of stroke is associated with unfavorable clinical course, including early neurologic worsening, delirium, depressed mood, impaired functional capacity and cognition, longer period of hospitalization and rehabilitation, and increased mortality. 1,7,9,10,36,37,[68][69][70][71][72] In addition, severe OSA not only increases the risk of stroke recurrence but also increases the incidence of fatal and nonfatal cardiovascular events as well as sudden death during sleep. 44,[73][74][75] The higher blood pressure and its swing during episodes of upper airways obstruction lead to worse outcome following stroke.…”

Section: Obstructive Sleep Apnea and Rehabilitation Outcomementioning

confidence: 99%

“…9,10 However, OSA is under-recognized during the poststroke period because of a lack of symptoms or lack of gross obesity, despite evidence that managing this risk factor may benefit those patients. 11 There is growing evidence that treatment of coexisting OSA with continuous positive airway pressure (CPAP) or mandibular advancement devices can successfully treat OSA, resulting in improved rehabilitation outcomes and improved health-related quality of life.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Jafari

2017

Sleep Medicine Clinics

View full text Add to dashboard Cite

Section: Prevalence Of Obstructive Sleep Apnea In the Poststroke Periodmentioning

confidence: 97%

Section: Prevalence Of Obstructive Sleep Apnea In the Poststroke Periodmentioning

confidence: 99%

Section: Prevalence Of Obstructive Sleep Apnea In the Poststroke Periodmentioning

confidence: 99%

Section: Obstructive Sleep Apnea and Rehabilitation Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Jafari

2017

Sleep Medicine Clinics

View full text Add to dashboard Cite

Oral Appliance Therapy in Patients With Daytime Sleepiness and Snoring or Mild to Moderate Sleep Apnea

et al. 2015

Self Cite

View full text Add to dashboard Cite

IMPORTANCE Oral appliances that move the mandible forward during sleep are suggested as treatment for mild to moderate obstructive sleep apnea.OBJECTIVE To test whether an adjustable, custom-made oral appliance improves daytime sleepiness and quality of life in patients with daytime sleepiness and snoring or mild to moderate obstructive sleep apnea. DESIGN, SETTING, AND PARTICIPANTS Ninety-six patients with daytime sleepiness and an apnea-hypopnea index (AHI) lower than 30 were included in a randomized, placebo-controlled, parallel trial in Umeå, Sweden, from May 2007 through August 2011.INTERVENTIONS Four months' intervention with an oral appliance or a placebo device. MAIN OUTCOMES AND MEASURES Daytime sleepiness was measured with the EpworthSleepiness Scale, the Karolinska Sleepiness Scale, and the Oxford Sleep Resistance (OSLER) test. Quality of life was assessed with the Short-Form 36-Item Health Survey (SF-36) and the Functional Outcomes of Sleep Questionnaire (FOSQ). Secondary outcomes included the apnea-hypopnea index, headaches, symptoms of restless legs, and insomnia.RESULTS Oral appliance therapy was not associated with improvements in daytime sleepiness from baseline to 4-month follow-up when compared with the placebo device; Epworth score >10: 53% at baseline to 24% at follow-up for the oral appliance group vs 54% at baseline to 40% at follow-up for the placebo device group, P = .11; median (IQR) for Karolinska score Ն7/wk: 10 (8 to 14) at baseline to 7 (4 to 9) at follow-up for the oral appliance group vs 12 (6 to 15) at baseline to 8 (5 to 12) at follow-up for the placebo device group, P = .11; mean between-group difference in OSLER test, −2.4 min (95% CI, −6.3 to 1.4). The mean between-group difference for the total FOSQ score was insignificant (−1.2 [95% CI, −2.5 to 0.1]). No domain of the SF-36 differed significantly between the groups. The AHI was below 5 in 49% of patients using the active appliance and in 11% using placebo, with an odds ratio of 7.8 (95% CI, 2.6-23.5) and a number needed to treat of 3. Snoring (P < .001) and symptoms of restless legs (P = .02) were less frequent when using the oral appliance vs placebo, but this did not apply to headache or insomnia. CONCLUSIONS AND RELEVANCEA custom-made, adjustable oral appliance reduces obstructive sleep apnea, snoring, and possibly restless legs without effects on daytime sleepiness and quality of life among patients with daytime sleepiness and snoring or mild to moderate sleep apnea. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00477009

show abstract

Sleep Disturbances after Stroke

Hermann

2010

Sleep Disorders in Neurology

View full text Add to dashboard Cite

Obstructive Sleep Apnea Is a Risk Factor for Death in Patients With Stroke

Abstract: Patients with stroke and obstructive sleep apnea have an increased risk of early death. Central sleep apnea was not related to early death among the present patients.

Cited by 306 publications

References 26 publications

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Oral Appliance Therapy in Patients With Daytime Sleepiness and Snoring or Mild to Moderate Sleep Apnea

Sleep Disturbances after Stroke

Contact Info

Product

Resources

About