Mollie McDermott1, Devin L Brown2, Chengwei Li3, Nelda M Garcia2, Erin Case3, Ronald D Chervin4, Lewis B Morgenstern5, Lynda D Lisabeth5. 1. University of Michigan Stroke Program, Cardiovascular Center, 3rd Floor, Reception C, 1500 East Medical Center Drive, SPC 5855, Ann Arbor, MI 48109-5855, USA. Electronic address: mcdermom@med.umich.edu. 2. University of Michigan Stroke Program, Cardiovascular Center, 3rd Floor, Reception C, 1500 East Medical Center Drive, SPC 5855, Ann Arbor, MI 48109-5855, USA. 3. University of Michigan Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, 4667 SPH I, Ann Arbor, MI 48109-2029, USA. 4. University of Michigan Sleep Disorders Center, 1500 East Medical Center Drive, C728 Med Inn Building, Ann Arbor, MI 48109-5845, USA. 5. University of Michigan Stroke Program and Department of Epidemiology Cardiovascular Center, 3rd Floor, Reception C, 1500 East Medical Center Drive, SPC 5855, Ann Arbor, MI 48109-5855, USA.
Abstract
OBJECTIVE/ BACKGROUND: Sleep-disordered breathing (SDB), an independent risk factor for stroke, is associated with worse post-stroke outcomes. Differences in the relationship between SDB and stroke may exist for women versus men. In this population-based study, we compared the prevalence of both pre- and post-stroke SDB by sex. We also explored whether menopausal status is related to post-stroke SDB. PATIENTS/ METHODS: We performed a cross-sectional study of subjects enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) project. Each subject (n = 1815) underwent a baseline interview including the Berlin Questionnaire to assess pre-stroke SDB risk and, if relevant, questions regarding menopausal status. Subjects were offered overnight SDB screening with a validated portable respiratory device (n = 832 with complete data). Log Poisson and linear regression models were used to assess the differences in SDB between men and women with adjustment for demographics, stroke risk factors, stroke severity, and other potential confounders. RESULTS: Women were less likely than men to be at high risk for pre-stroke SDB (56.6% versus 61.9%) (prevalence ratio [PR] 0.87 for women; 95% confidence interval [CI], 0.81-0.95). A lower proportion of women than men (50.8% versus 70.2%) had post-stroke SDB by respiratory monitoring (PR 0.71; 95% CI, 0.63-0.80). SDB severity was higher for men than for women (mean difference in respiratory event index [REI] 6.5; 95% CI, 4.3-8.7). No significant association existed between post-stroke SDB and either menopausal status or age at menopause. CONCLUSIONS: After acute ischemic stroke, SDB was more prevalent and more severe in men than in women.
OBJECTIVE/ BACKGROUND:Sleep-disordered breathing (SDB), an independent risk factor for stroke, is associated with worse post-stroke outcomes. Differences in the relationship between SDB and stroke may exist for women versus men. In this population-based study, we compared the prevalence of both pre- and post-stroke SDB by sex. We also explored whether menopausal status is related to post-stroke SDB. PATIENTS/ METHODS: We performed a cross-sectional study of subjects enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) project. Each subject (n = 1815) underwent a baseline interview including the Berlin Questionnaire to assess pre-stroke SDB risk and, if relevant, questions regarding menopausal status. Subjects were offered overnight SDB screening with a validated portable respiratory device (n = 832 with complete data). Log Poisson and linear regression models were used to assess the differences in SDB between men and women with adjustment for demographics, stroke risk factors, stroke severity, and other potential confounders. RESULTS:Women were less likely than men to be at high risk for pre-stroke SDB (56.6% versus 61.9%) (prevalence ratio [PR] 0.87 for women; 95% confidence interval [CI], 0.81-0.95). A lower proportion of women than men (50.8% versus 70.2%) had post-stroke SDB by respiratory monitoring (PR 0.71; 95% CI, 0.63-0.80). SDB severity was higher for men than for women (mean difference in respiratory event index [REI] 6.5; 95% CI, 4.3-8.7). No significant association existed between post-stroke SDB and either menopausal status or age at menopause. CONCLUSIONS: After acute ischemic stroke, SDB was more prevalent and more severe in men than in women.
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