Screening for OSA in stroke patients: The role of a sleep educator

Sanchez, Oriana; Adra, Nour; Chuprevich, Scott; Attarian, Hrayr

doi:10.1016/j.sleep.2022.08.024

Cited by 8 publications

(9 citation statements)

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“…First, elderly patients with OSA and prior stroke/TIA, particularly male and Asian/Pacific Islander patients, should be closely monitored for the development of subsequent strokes. Patients with OSA are typically not screened for OSA in busy stroke clinics and inpatient settings, as the stroke team is typically overburdened with work and must address higher-priority health issues [ 2 ]. This may prevent many stroke patients from missing the screening for OSA, leading to subsequent strokes [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with OSA are typically not screened for OSA in busy stroke clinics and inpatient settings, as the stroke team is typically overburdened with work and must address higher-priority health issues [ 2 ]. This may prevent many stroke patients from missing the screening for OSA, leading to subsequent strokes [ 2 ]. Consequently, the role of Sleep Educators can enhance screening [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…This may prevent many stroke patients from missing the screening for OSA, leading to subsequent strokes [ 2 ]. Consequently, the role of Sleep Educators can enhance screening [ 2 ]. The sleep educator is a sleep center nurse with training in sleep medicine.…”

Section: Discussionmentioning

confidence: 99%

“…Obstructive Sleep Apnea (OSA) has been recognized as a risk factor for stroke and cardiovascular events, and the prevalence of OSA is particularly high in elderly patients [ 1 ]. A prior stroke or transient ischemic attack (TIA) is also associated with an increased risk of subsequent/recurrent stroke [ 2 ]. However, little is known about the burden and impact of OSA on recurrent/subsequent stroke and associated hospitalization outcomes in geriatric patients (G-OSA) with prior stroke/TIA.…”

Section: Introductionmentioning

confidence: 99%

“…A systematic review and meta-analysis showed that sleep disturbance is associated with an increased risk of recurrent cardiovascular and cerebrovascular events in patients who have already experienced a stroke [ 1 ]. In addition, screening for OSA in stroke patients may identify those at risk for stroke recurrence [ 2 ]. However, there is a lack of information about the relationship between OSA and subsequent/recurrent stroke in geriatric patients with prior stroke/TIA.…”

Section: Introductionmentioning

confidence: 99%

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Recurrent/Subsequent Stroke and Associated Outcomes in Geriatric Patients with OSA and Prior Stroke Events: A Retrospective Study Using the 2019 National Inpatient Sample

Desai

Singh

Mellacheruvu

et al. 2023

JPM

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Background: Obstructive sleep apnea (OSA) increases the risk of stroke and cardiovascular diseases. However, its impact on geriatric patients with a prior history of stroke/transient ischemic attack (TIA) has not been adequately studied. Methods: We utilized the 2019 National Inpatient Sample in the US to identify geriatric patients with OSA (G-OSA) who had a prior history of stroke/TIA. We then compared subsequent stroke (SS) rates among sex and race subgroups. We also compared the demographics and comorbidities of SS+ and SS− groups and utilized logistic regression models to assess outcomes. Results: Out of 133,545 G-OSA patients admitted with a prior history of stroke/TIA, 4.9% (6520) had SS. Males had a higher prevalence of SS, while Asian-Pacific Islanders and Native Americans had the highest prevalence of SS, followed by Whites, Blacks, and Hispanics. The SS+ group had higher all-cause in-hospital mortality rates, with Hispanics showing the highest rate compared to Whites and Blacks (10.6% vs. 4.9% vs. 4.4%, p < 0.001), respectively. Adjusted analysis for covariates showed that complicated and uncomplicated hypertension (aOR 2.17 [95% CI 1.78–2.64]; 3.18 [95% CI 2.58–3.92]), diabetes with chronic complications (aOR 1.28 [95% CI 1.08–1.51]), hyperlipidemia (aOR 1.24 [95% CI 1.08–1.43]), and thyroid disorders (aOR 1.69 [95% CI 1.14–2.49]) were independent predictors of SS. The SS+ group had fewer routine discharges and higher healthcare costs. Conclusions: Our study shows that about 5% of G-OSA patients with a prior history of stroke/TIA are at risk of hospitalization due to SS, which is associated with higher mortality and healthcare utilization. Complicated and uncomplicated hypertension, diabetes with chronic complications, hyperlipidemia, thyroid disorders, and admission to rural hospitals predict subsequent stroke.

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Section: Discussionmentioning

confidence: 99%