Justine A Aaronson1,2, Coen A M van Bennekom1, Winni F Hofman2, Tijs van Bezeij1, Joost G van den Aardweg3, Erny Groet1, Wytske A Kylstra1, Ben Schmand2,4. 1. Heliomare Research and Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands. 2. Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands. 3. Department of Pulmonary Medicine, Medical Center Alkmaar, Alkmaar, Netherlands. 4. Department of Neurology, Academic Medical Center, Amsterdam, Netherlands.
Abstract
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a common sleep disorder in stroke patients and is associated with prolonged hospitalization, decreased functional outcome, and recurrent stroke. Research on the effect of OSA on cognitive functioning following stroke is scarce. The primary objective of this study was to compare stroke patients with and without OSA on cognitive and functional status upon admission to inpatient rehabilitation. DESIGN: Case-control study. SETTING AND PATIENTS: 147 stroke patients admitted to a neurorehabilitation unit. INTERVENTIONS: N/A. MEASUREMENTS: All patients underwent sleep examination for diagnosis of OSA. We assessed cognitive status by neuropsychological examination and functional status by two neurological scales and a measure of functional independence. RESULTS: We included 80 stroke patients with OSA and 67 stroke patients without OSA. OSA patients were older and had a higher body mass index than patients without OSA. OSA patients performed worse on tests of attention, executive functioning, visuoperception, psychomotor ability, and intelligence than those without OSA. No differences were found for vigilance, memory, and language. OSA patients had a worse neurological status, lower functional independence scores, and a longer period of hospitalization in the neurorehabilitation unit than the patients without OSA. OSA status was not associated with stroke type or classification. CONCLUSIONS: Obstructive sleep apnea (OSA) is associated with a lower cognitive and functional status in patients admitted for stroke rehabilitation. This underlines the importance of OSA as a probable prognostic factor, and calls for well-designed randomized controlled trials to study its treatability.
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a common sleep disorder in strokepatients and is associated with prolonged hospitalization, decreased functional outcome, and recurrent stroke. Research on the effect of OSA on cognitive functioning following stroke is scarce. The primary objective of this study was to compare strokepatients with and without OSA on cognitive and functional status upon admission to inpatient rehabilitation. DESIGN: Case-control study. SETTING AND PATIENTS: 147 strokepatients admitted to a neurorehabilitation unit. INTERVENTIONS: N/A. MEASUREMENTS: All patients underwent sleep examination for diagnosis of OSA. We assessed cognitive status by neuropsychological examination and functional status by two neurological scales and a measure of functional independence. RESULTS: We included 80 strokepatients with OSA and 67 strokepatients without OSA. OSA patients were older and had a higher body mass index than patients without OSA. OSA patients performed worse on tests of attention, executive functioning, visuoperception, psychomotor ability, and intelligence than those without OSA. No differences were found for vigilance, memory, and language. OSA patients had a worse neurological status, lower functional independence scores, and a longer period of hospitalization in the neurorehabilitation unit than the patients without OSA. OSA status was not associated with stroke type or classification. CONCLUSIONS: Obstructive sleep apnea (OSA) is associated with a lower cognitive and functional status in patients admitted for stroke rehabilitation. This underlines the importance of OSA as a probable prognostic factor, and calls for well-designed randomized controlled trials to study its treatability.
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Authors: Justine A Aaronson; Winni F Hofman; Coen A M van Bennekom; Tijs van Bezeij; Joost G van den Aardweg; Erny Groet; Wytske A Kylstra; Ben Schmand Journal: J Clin Sleep Med Date: 2016-04-15 Impact factor: 4.062