Supine sleep and positional sleep apnea after acute ischemic stroke and intracerebral hemorrhage


Autoria(s): Camilo, Millene R.; Fernandes, Regina M. F.; Sander, Heidi H.; Nobre, Fernando; Santos-Pontelli, Taiza; dos Santos, Antonio C.; de Araujo, Draulio B.; Leite, Joao P.; Pontes-Neto, Octavio M.
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

04/11/2013

04/11/2013

2012

Resumo

OBJECTIVE: Obstructive sleep apnea is frequent during the acute phase of stroke, and it is associated with poorer outcomes. A well-established relationship between supine sleep and obstructive sleep apnea severity exists in non-stroke patients. This study investigated the frequency of supine sleep and positional obstructive sleep apnea in patients with ischemic or hemorrhagic stroke. METHODS: Patients who suffered their first acute stroke, either ischemic or hemorrhagic, were subjected to a full polysomnography, including the continuous monitoring of sleep positions, during the first night after symptom onset. Obstructive sleep apnea severity was measured using the apnea-hypopnea index, and the NIHSS measured stroke severity. RESULTS: We prospectively studied 66 stroke patients. The mean age was 57.6+/-11.5 years, and the mean body mass index was 26.5+/-4.9. Obstructive sleep apnea (apnea-hypopnea index >= 5) was present in 78.8% of patients, and the mean apnea-hypopnea index was 29.7+/-26.6. The majority of subjects (66.7%) spent the entire sleep time in a supine position, and positional obstructive sleep apnea was clearly present in the other 23.1% of cases. A positive correlation was observed between the NIHSS and sleep time in the supine position (r(s) = 0.5; p<0.001). CONCLUSIONS: Prolonged supine positioning during sleep was highly frequent after stroke, and it was related to stroke severity. Positional sleep apnea was observed in one quarter of stroke patients, which was likely underestimated during the acute phase of stroke. The adequate positioning of patients during sleep during the acute phase of stroke may decrease obstructive respiratory events, regardless of the stroke subtype.

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)

Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)

Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)

Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)

Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)

Identificador

CLINICS, SAO PAULO, v. 67, n. 12, supl. 1, Part 3, pp. 1357-1360, JUN, 2012

1807-5932

http://www.producao.usp.br/handle/BDPI/40837

10.6061/clinics/2012(12)02

http://dx.doi.org/10.6061/clinics/2012(12)02

Idioma(s)

eng

Publicador

HOSPITAL CLINICAS, UNIV SAO PAULO

SAO PAULO

Relação

CLINICS

Direitos

openAccess

Copyright HOSPITAL CLINICAS, UNIV SAO PAULO

Palavras-Chave #STROKE #SLEEP APNEA #SUPINE #POSITIONAL #INTRACEREBRAL HEMORRHAGE #PREVALENCE #DIAGNOSIS #SEVERITY #MEDICINE, GENERAL & INTERNAL
Tipo

article

original article

publishedVersion