Laura B Ponsaing1,2, Helle K Iversen3, Poul Jennum4,5. 1. Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet - Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, DK-2600, Glostrup, Denmark. laura_ponsaing@hotmail.com. 2. Center for Healthy Aging, Copenhagen University, Blegdamsvej 3b, DK-2200, Copenhagen N, Denmark. laura_ponsaing@hotmail.com. 3. The Stroke Unit, Department of Neurology, Rigshospitalet - Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, DK-2600, Glostrup, Denmark. 4. Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet - Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, DK-2600, Glostrup, Denmark. 5. Center for Healthy Aging, Copenhagen University, Blegdamsvej 3b, DK-2200, Copenhagen N, Denmark.
Abstract
PURPOSE: The purpose of the study was to assess polysomnographic indicators of increased mortality risk in patients with stroke or a transient ischemic attack (TIA). METHODS: We performed polysomnographies in 63 acute stroke/TIA patients. Mortality data were collected from a national database after a 19-37-month follow-up period. RESULTS: Of the 57 stroke and 6 TIA patients, 9 stroke patients died during follow-up. All nine had moderate or severe sleep-related breathing disorders (SRBDs). Binarily divided, the group with the highest apnea hypopnea index (AHI) had an almost 10-fold higher mortality risk (hazard ratio (HR) 9.71; 95 % confidence interval (CI) 1.20-78.29; p = 0.033) compared to the patients with the lowest AHI. The patients with the longest versus shortest nocturnal wake time had a higher mortality (HR 8.78; 95 % CI 1.1-71.8; p = 0.0428). Lung disease increased mortality (HR 9.92; 95 % CI 2.00-49.23; p = 0.005), and there was a trend toward a higher mortality risk with atrial fibrillation/flutter (HR 3.63; 95 % CI 0.97-13.51; p = 0.055). CONCLUSIONS: In stroke patients, the AHI and nocturnal wake time are indicators of increased mortality risk. SRBDs in stroke patients should receive increased attention.
PURPOSE: The purpose of the study was to assess polysomnographic indicators of increased mortality risk in patients with stroke or a transient ischemic attack (TIA). METHODS: We performed polysomnographies in 63 acute stroke/TIApatients. Mortality data were collected from a national database after a 19-37-month follow-up period. RESULTS: Of the 57 stroke and 6 TIApatients, 9 strokepatients died during follow-up. All nine had moderate or severe sleep-related breathing disorders (SRBDs). Binarily divided, the group with the highest apnea hypopnea index (AHI) had an almost 10-fold higher mortality risk (hazard ratio (HR) 9.71; 95 % confidence interval (CI) 1.20-78.29; p = 0.033) compared to the patients with the lowest AHI. The patients with the longest versus shortest nocturnal wake time had a higher mortality (HR 8.78; 95 % CI 1.1-71.8; p = 0.0428). Lung disease increased mortality (HR 9.92; 95 % CI 2.00-49.23; p = 0.005), and there was a trend toward a higher mortality risk with atrial fibrillation/flutter (HR 3.63; 95 % CI 0.97-13.51; p = 0.055). CONCLUSIONS: In strokepatients, the AHI and nocturnal wake time are indicators of increased mortality risk. SRBDs in strokepatients should receive increased attention.
Entities:
Keywords:
Mortality; Polysomnography; Sleep-related breathing disorders; Stroke; Transient ischemic attack; Wake time
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