Sleep-disordered breathing in the acute phase of transient ischemic attack and minor stroke

Objectives: Obstructive sleep apnea represents an independent risk factor for cerebrovascular events. Here we describe the clinical and sleep related respiratory features of a consecutive series of patients with acute minor ischemic stroke (MS) or transient ischemic attack (TIA) enrolled in a previous cross-sectional study (Ciccone et al., Thorax 2013). Methods: We prospectively considered patients admitted to 13 stroke units for acute MS or TIA submitted to a cardio-respiratory sleep study within 10 days of the onset of symptoms. Results: We enrolled 356 patients. A Sleep Disordered Breathing (i.e. apnea hypopnea index >5, SDB) was found in 67.7% of patientsThe SDB was prevalently obstructive in 153, mixed in 55 and central in 33 patients. Non parametric statistical analyses (Kruskall-Wallis, Mann-Whitney, Chi-Square tests) revealed different variables signif- icantly associated with SDB: age, male gender, oral anatomy according to Mallampati, body mass index, neck circumference, neurological deficits, previous cardiovascular events, hypertension, diabetes, hypercholesterolemia, carotid artery stenosis, and high risk of SDB at the Berlin questionnaire. Patients with a pure central SDB (33 subjects) did not show a statistical significant association with hypertension, diabetes and a high risk of SDB at the Berlin questionnaire. Conclusions: Our data show a high prevalence of SDB during the acute phase of a mild cerebrovascular event. The presence of a SDB should be investigated in patients admitted in a stroke unit, especially in subjects with a history of hypertension, diabetes, previous cardiovascular events and a high risk of SDB at the Berlin questionnaire.