No Difference in Sleep Desaturations Severity between Patients with Wake-Up and Non-Wake-Up Stroke: A PRESS Study Results

. 2023 Feb 13 ; 13 (2) : . [epub] 20230213

Status PubMed-not-MEDLINE Jazyk angličtina Země Švýcarsko Médium electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid36836872

BACKGROUND: Wake-up stroke (WUS) is a certain type of ischemic stroke in which a patient wakes up with a new neurological deficit due to cerebral ischemia. Sleep-disordered breathing is an independent risk factor for stroke, but the role of nocturnal oxygen desaturation in the pathophysiology of WUS is still insufficiently explored. According to several studies, patients with WUS have a significantly more severe sleep apnea syndrome and lower mean blood oxygen saturation. This study aimed to assess the severity of nocturnal desaturations in acute WUS and non-WUS patients using nocturnal pulse oximetry. MATERIAL AND METHODS: The cohort of 225 consecutive patients with neuroimaging-verified acute cerebral ischemia was prospectively enrolled. For further analyses, 213 subjects with known WUS/non-WUS status were selected (111 males and 102 females, average age 70.4 ±12.9, median baseline NIHSS = 5, median baseline mRS = 3). Patients were divided into the WUS group (n = 45) and the non-WUS group (n = 168). Overnight pulse oximetry was performed within 7 days of the stroke onset and data of both of the studied groups were compared. RESULTS: We found oxygen desaturation index (ODI) in the WUS group was 14.5 vs. 16.6 (p = 0.728) in the non-WUS group, basal O2 saturation was 92.2% vs. 92.5% (p = 0.475), average low O2 saturation was 90.3% vs. 89.6% (p = 0.375), minimal O2 saturation was 79.5% vs. 80.6% (p = 0.563), and time with O2 saturation <90% (T90) was 4.4% vs. 4.7% (p = 0.729). CONCLUSIONS: In the studied sample, monitored respiratory parameters including ODI, basal O2 saturation, average low O2 saturation, minimal O2 saturation, and T90 did not significantly differ between groups of WUS and non-WUS patients.

Zobrazit více v PubMed

Mackey J., Kleindorfer D., Sucharew H., Moomaw C.J., Kissela B.M., Alwell K., Flaherty M.L., Woo D., Khatri P., Adeoye O., et al. Population-based study of wake-up strokes. Neurology. 2011;76:1662–1667. doi: 10.1212/WNL.0b013e318219fb30. PubMed DOI PMC

Sun T., Xu Z., Diao S.S., Zhang L.L., Fang Q., Cai X.Y., Kong Y. Safety and cost-effectiveness thrombolysis by diffusion-weighted imaging and fluid attenuated inversion recovery mismatch for wake-up stroke. Clin. Neurol. Neurosurg. 2018;170:47–52. doi: 10.1016/j.clineuro.2018.04.027. PubMed DOI

Tsai J.P., Albers G.W. Wake-Up Stroke: Current Understanding. Top. Magn. Reson. Imaging TMRI. 2017;26:97–102. doi: 10.1097/RMR.0000000000000126. PubMed DOI

Arzt M., Young T., Finn L., Skatrud J.B., Bradley T.D. Association of sleep-disordered breathing and the occurrence of stroke. Am. J. Respir. Crit. Care Med. 2005;172:1447–1451. doi: 10.1164/rccm.200505-702OC. PubMed DOI PMC

Šiarnik P., Kollár B., Čarnická Z., Šurda P., Klobučníková K., Sýkora M., Turčáni P. Association of Sleep Disordered Breathing with Wake-Up Acute Ischemic Stroke: A Full Polysomnographic Study. J. Clin. Sleep Med. JCSM: Off. Publ. Am. Acad. Sleep Med. 2016;12:549–554. doi: 10.5664/jcsm.5688. PubMed DOI PMC

Hsieh S.W., Lai C.L., Liu C.K., Hsieh C.F., Hsu C.Y. Obstructive sleep apnea linked to wake-up strokes. J. Neurol. 2012;259:1433–1439. doi: 10.1007/s00415-011-6370-9. PubMed DOI

Kim T.J., Ko S.B., Jeong H.G., Lee J.S., Kim C.K., Kim Y., Nam K., Mo H., Joon An S., Choi H.A., et al. Nocturnal Desaturation in the Stroke Unit Is Associated With Wake-Up Ischemic Stroke. Stroke. 2016;47:1748–1753. doi: 10.1161/STROKEAHA.116.013266. PubMed DOI

Lu X., Liu W., Wang H. Investigating the Association between Wake-Up Stroke and Obstructive Sleep Apnea: A Meta-Analysis. Eur. Neurol. 2022;85:14–23. doi: 10.1159/000517916. PubMed DOI

Ott S.R., Korostovtseva L., Schmidt M., Horvath T., Brill A.K., Bassetti C.L. Sleep-disordered breathing: Clinical features, pathophysiology and diagnosis. Swiss Med. Wkly. 2017;147:w14436. doi: 10.4414/smw.2017.14436. PubMed DOI

Kim J.S., Kim S., Lee S.H., Lee H.Y., Lee S.Y., Im K.B. Increased Risk of Ischemic Stroke during Sleep in Apneic Patients. J. Clin. Neurol. 2018;14:174–178. doi: 10.3988/jcn.2018.14.2.174. PubMed DOI PMC

Lin S.H., Branson C., Leung J., Park L., Doshi N., Auerbach S.H. Oximetry as an Accurate Tool for Identifying Moderate to Severe Sleep Apnea in Patients With Acute Stroke. J. Clin. Sleep Med. 2018;14:2065–2073. doi: 10.5664/jcsm.7538. PubMed DOI PMC

Chung F., Liao P., Elsaid H., Islam S., Shapiro C.M., Sun Y. Oxygen desaturation index from nocturnal oximetry: A sensitive and specific tool to detect sleep-disordered breathing in surgical patients. Anesth Analg. 2012;114:993–1000. doi: 10.1213/ANE.0b013e318248f4f5. PubMed DOI

Linz D., Kadhim K., Brooks A.G., Elliott A.D., Hendriks J.M.L., Lau D.H., Mahajan R., Gupta A.K., Middeldorp M.E., Hohl M., et al. Diagnostic accuracy of overnight oximetry for the diagnosis of sleep-disordered breathing in atrial fibrillation patients. Int. J. Cardiol. 2018;272:155–161. doi: 10.1016/j.ijcard.2018.07.124. PubMed DOI

Šiarnik P., Jurík M., Veverka J., Klobučníková K., Kollár B., Turčáni P., Sýkora M. Pulse oximetric routine examination of sleep apnea in acute stroke (PRESS) Sleep Med. 2020;73:208–212. doi: 10.1016/j.sleep.2020.06.035. PubMed DOI

Ward N.R., Cowie M.R., Rosen S.D., Roldao V., De Villa M., McDonagh T.A., Simonds A., Morrell M.J. Utility of overnight pulse oximetry and heart rate variability analysis to screen for sleep-disordered breathing in chronic heart failure. Thorax. 2012;67:1000–1005. doi: 10.1136/thoraxjnl-2012-201684. PubMed DOI

Šiarnik P., Jurík M., Valovičová K., Klobučníková K., Kollár B., Poddaný M., Rovňák M., Turčáni P., Sýkora M. Adherence to positive airway pressure therapy initiated in the early subacute phase of ischemic stroke: A PRESS study follow-up. Sleep Breath. 2022;5:1–8. doi: 10.1007/s11325-022-02722-y. PubMed DOI PMC

Brott T., Adams H.P., Jr., Olinger C.P., Marler J.R., Barsan W.G., Biller J., Spilker J., Holleran R., Eberle R., Hertzberg V., et al. Measurements of acute cerebral infarction: A clinical examination scale. Stroke. 1989;20:864–870. doi: 10.1161/01.STR.20.7.864. PubMed DOI

Sulter G., Steen C., De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke. 1999;30:1538–1541. doi: 10.1161/01.STR.30.8.1538. PubMed DOI

Šiarnik P., Kollár B., Čarnická Z., Šutovský S., Klobučníková K., Turčáni P. Characteristics of Sleep-Disordered Breathing in Etiologic Subtypes of Minor-to-Moderate Acute Ischemic Stroke. J. Stroke Cerebrovasc. Dis. Off. J. Natl. Stroke Assoc. 2015;24:1087–1093. doi: 10.1016/j.jstrokecerebrovasdis.2015.01.023. PubMed DOI

Rundo J.V., Downey R., 3rd Polysomnography. Handb. Clin. Neurol. 2019;160:381–392. doi: 10.1016/b978-0-444-64032-1.00025-4. PubMed DOI

Lee J.J., Sundar K.M. Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome. Lung. 2021;199:87–101. doi: 10.1007/s00408-021-00426-w. PubMed DOI

Slouka D., Honnerova M., Hosek P., Gal B., Trcka O., Kostlivy T., Landsmanova J., Havel D., Baneckova M., Kucera R. Improved prediction of CPAP failure using T90, age and gender. J. Appl. Biomed. 2019;17:81. doi: 10.32725/jab.2018.008. PubMed DOI

Sánchez-de-la-Torre M., Sánchez-de-la-Torre A., Bertran S., Abad J., Duran-Cantolla J., Cabriada V., Mediano O., Masdeu M.J., Alonso M.L., Masa J.F., et al. Effect of obstructive sleep apnoea and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome (ISAACC study): A randomised controlled trial. Lancet Respir. Med. 2020;8:359–367. doi: 10.1016/S2213-2600(19)30271-1. PubMed DOI

Solecka Š., Matler K., Kostlivý T., Kubec V., Tomášková H., Betka J. A Comparison of the Reliability of Five Sleep Questionnaires for the Detection of Obstructive Sleep Apnea. Life. 2022;12:1416. doi: 10.3390/life12091416. PubMed DOI PMC

Reuter H., Herkenrath S., Treml M., Halbach M., Steven D., Frank K., Castrogiovanni A., Kietzmann I., Baldus S., Randerath W.J. Sleep-disordered breathing in patients with cardiovascular diseases cannot be detected by ESS, STOP-BANG, and Berlin questionnaires. Clin. Res. Cardiol. Off. J. Ger. Card. Soc. 2018;107:1071–1078. doi: 10.1007/s00392-018-1282-7. PubMed DOI

Slouka D., Windrichova J., Rezackova H., Houfkova K., Kucera R., Cerna V., Kostlivy T., Topolcan O., Pesta M. The potential of miR-499 plasmatic level as a biomarker of obstructive sleep apnea syndrome. Biomark. Med. 2021;15:1011–1019. doi: 10.2217/bmm-2020-0826. PubMed DOI

Slouka D., Kucera R., Gal B., Betka J., Skalova A. Biomarkers—A possibility for monitoring of obstructive sleep apnea syndrome. Neuro Endocrinol. Lett. 2019;40:85–92. PubMed

Hornero R., Alvarez D., Abásolo D., del Campo F., Zamarrón C. Utility of approximate entropy from overnight pulse oximetry data in the diagnosis of the obstructive sleep apnea syndrome. IEEE Trans. Bio-Med. Eng. 2007;54:107–113. doi: 10.1109/TBME.2006.883821. PubMed DOI

Yatsu S., Naito R., Kasai T., Matsumoto H., Shitara J., Shimizu M., Murata A., Kato T., Suda S., Hiki M., et al. Influence of sleep-disordered breathing assessed by pulse oximetry on long-term clinical outcomes in patients who underwent percutaneous coronary intervention. Clin. Res. Cardiol. Off. J. Ger. Card. Soc. 2018;107:711–718. doi: 10.1007/s00392-018-1238-y. PubMed DOI

Bassetti C.L. Sleep and stroke. Semin. Neurol. 2005;25:19–32. doi: 10.1055/s-2005-867073. PubMed DOI

Seiler A., Camilo M., Korostovtseva L., Haynes A.G., Brill A.K., Horvath T., Egger M., Bassetti C.L. Prevalence of sleep-disordered breathing after stroke and TIA: A meta-analysis. Neurology. 2019;92:e648–e654. doi: 10.1212/WNL.0000000000006904. PubMed DOI

Schütz S.G., Lisabeth L.D., Gibbs R., Shi X., Case E., Chervin R.D., Brown D.L. Wake-up stroke is not associated with obstructive sleep apnea. Sleep Med. 2021;81:158–162. doi: 10.1016/j.sleep.2021.02.010. PubMed DOI PMC

Haula T.M., Puustinen J., Takala M., Holm A. Wake-up strokes are linked to obstructive sleep apnea and worse early functional outcome. Brain Behav. 2021;11:e2284. doi: 10.1002/brb3.2284. PubMed DOI PMC

Barreto P.R., Diniz D.L.O., Lopes J.P., Barroso M.C., Daniele T., de Bruin P.F.C., de Bruin V.M.S. Obstructive Sleep Apnea and Wake-up Stroke—A 12 Months Prospective Longitudinal Study. J. Stroke Cerebrovasc. Dis. Off. J. Natl. Stroke Assoc. 2020;29:104564. doi: 10.1016/j.jstrokecerebrovasdis.2019.104564. PubMed DOI

Brown D.L., Li C., Chervin R.D., Case E., Garcia N.M., Tower S.D., Lisabeth L.D. Wake-up stroke is not associated with sleep-disordered breathing in women. Neurology. Clin. Pract. 2018;8:8–14. doi: 10.1212/CPJ.0000000000000412. PubMed DOI PMC

Slonkova J., Bar M., Nilius P., Berankova D., Salounova D., Sonka K. Spontaneous improvement in both obstructive sleep apnea and cognitive impairment after stroke. Sleep Med. 2017;32:137–142. doi: 10.1016/j.sleep.2016.11.024. PubMed DOI

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...