Tae Jung Kim1, Sang-Bae Ko2, Han-Gil Jeong1, Ji Sung Lee1, Chi Kyung Kim1, Yerim Kim1, Kiwoong Nam1, Heejung Mo1, Sang Joon An1, Huimahn Alex Choi1, Byung-Woo Yoon1. 1. From the Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (T.J.K., S.-B.K., H.-G.J., K.N., H.M., S.J.A., B.-W.Y.); Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neruology, Korea University Guro Hospital, Seoul, Republic of Korea (C.K.K.); Department of Neurology, Bucheon St. Mary's Hospital, Gyeonggi-do, Republic of Korea (Y.K.); and Department of Neurology and Neurosurgery, The Mischer Neuroscience Institute, Memorial Hermann of Texas Medical Center, Houston, TX (H.A.C.). 2. From the Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (T.J.K., S.-B.K., H.-G.J., K.N., H.M., S.J.A., B.-W.Y.); Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neruology, Korea University Guro Hospital, Seoul, Republic of Korea (C.K.K.); Department of Neurology, Bucheon St. Mary's Hospital, Gyeonggi-do, Republic of Korea (Y.K.); and Department of Neurology and Neurosurgery, The Mischer Neuroscience Institute, Memorial Hermann of Texas Medical Center, Houston, TX (H.A.C.). sangbai1378@gmail.com.
Abstract
BACKGROUND AND PURPOSE: Wake-up stroke (WUS) represents a quarter of all ischemic strokes and may be a specific subgroup. Nocturnal desaturation secondary to sleep-disordered breathing is an independent risk factor for stroke, but the association between nocturnal desaturation and WUS remains unclear. We investigated the relationship between nocturnal desaturation using oxygen desaturation index and WUS in patients with acute stroke in the stroke unit. METHODS: A total of 298 patients admitted for acute ischemic stroke to the stroke unit between July 2013 and May 2015 were enrolled. The oxygen desaturation index was calculated using pulse oximetry data sampled every 1 minute during 9 hours on the first night (10:00 pm-7:00 am) of the stroke unit admission, and nocturnal desaturation was defined as an oxygen desaturation index of 5 at least per hour. We compared the clinical characteristics and nocturnal desaturations between patients with and without WUS. RESULTS: Among all patients (age, 67.7±12.6 years; male, 54.4%), 26.5% patients had WUS. The proportion of nocturnal desaturation was significantly greater in patients admitted with WUS (29.1% versus 12.3%, P=0.001). The age, sex, risk factors except for hyperlipidemia, stroke severity, and stroke mechanisms were similar between the 2 groups. After adjustment for covariates, it was found that nocturnal desaturation was significantly more common in the WUS group (odds ratio, 3.25; 95% confidence interval, 1.63-6.46). CONCLUSIONS: Nocturnal desaturation was more frequently observed in patients admitted with WUS during the first night in the stroke unit. This suggests that nocturnal desaturation is a possible modifiable risk factor for the occurrence of WUS.
BACKGROUND AND PURPOSE: Wake-up stroke (WUS) represents a quarter of all ischemic strokes and may be a specific subgroup. Nocturnal desaturation secondary to sleep-disordered breathing is an independent risk factor for stroke, but the association between nocturnal desaturation and WUS remains unclear. We investigated the relationship between nocturnal desaturation using oxygen desaturation index and WUS in patients with acute stroke in the stroke unit. METHODS: A total of 298 patients admitted for acute ischemic stroke to the stroke unit between July 2013 and May 2015 were enrolled. The oxygen desaturation index was calculated using pulse oximetry data sampled every 1 minute during 9 hours on the first night (10:00 pm-7:00 am) of the stroke unit admission, and nocturnal desaturation was defined as an oxygen desaturation index of 5 at least per hour. We compared the clinical characteristics and nocturnal desaturations between patients with and without WUS. RESULTS: Among all patients (age, 67.7±12.6 years; male, 54.4%), 26.5% patients had WUS. The proportion of nocturnal desaturation was significantly greater in patients admitted with WUS (29.1% versus 12.3%, P=0.001). The age, sex, risk factors except for hyperlipidemia, stroke severity, and stroke mechanisms were similar between the 2 groups. After adjustment for covariates, it was found that nocturnal desaturation was significantly more common in the WUS group (odds ratio, 3.25; 95% confidence interval, 1.63-6.46). CONCLUSIONS: Nocturnal desaturation was more frequently observed in patients admitted with WUS during the first night in the stroke unit. This suggests that nocturnal desaturation is a possible modifiable risk factor for the occurrence of WUS.
Authors: Jin Soo Kim; Seongheon Kim; Seung Hwan Lee; Hee Young Lee; Seo Young Lee; Kyoung Bin Im Journal: J Clin Neurol Date: 2018-02-28 Impact factor: 3.077
Authors: Devin L Brown; Chengwei Li; Ronald D Chervin; Erin Case; Nelda M Garcia; Susan D Tower; Lynda D Lisabeth Journal: Neurol Clin Pract Date: 2018-02