Sleep-disordered Breathing and Cardiovascular Diseases
Chung-Yao HSU, M.D., Ph.D.
Department of Neurology and Sleep Disorders Center
Kaohsiung Medical University Hospital
Sleep-disordered breathing (SDB) is considered as an independent risk factor for cardiovascular diseases, but the direct impact of SDB on ischemic stroke onset during sleep or after awakening was not well studied. We recruited mild to moderate ischemic stroke patients and they were classified into sleep-related and non-sleep-related ischemic stroke based on the stroke onset time. All patients had overnight limited sleep study between 3 to 14 days after stroke onset, from which we collected breathing-related parameters including Apnea-hypopnea index (AHI), average blood saturation, minimum blood saturation, average desaturation and heart rate variability. We also used the Chinese version of Epworth sleepiness scales (ESS), Pittsburg sleep questionnaire index (PSQI), scoring outcome scales (SOS) to evaluate excessive daytime sleepiness, sleep quality and snoring respectively. Seventy-four ischemic stroke patients were enrolled in this study. Thirty-eight (51.4%) patients were sleep-related stroke and 36 (48.6%) patients were non-sleep-related stroke. The patients with sleep-related ischemic stroke had significant higher AHI than those with non-sleep-related ischemic stroke. There was no significant difference in daytime sleepiness, sleep quality, snoring, hospitalization days, prognosis, stroke classification between two groups. After adjusting for confounding factors, severe sleep-disordered breathing (with AHI >30) was an independent factor for sleep-related ischemic stroke. These findings might further support the important role of SDB in cardiovascular diseases.
