Devin L Brown1, Chengwei Li1, Ronald D Chervin1, Erin Case1, Nelda M Garcia1, Susan D Tower1, Lynda D Lisabeth1. 1. Stroke Program (DLB, CL, EC, NMG, LDL) and Sleep Disorders Center and Department of Neurology (RDC), University of Michigan Medical School; Department of Epidemiology (CL, EC, NMG, LDL), University of Michigan School of Public Health, Ann Arbor; and Corpus Christi physician (SDT), TX.
Abstract
BACKGROUND: We sought to investigate the frequency of wake-up stroke (WUS) and its association with sleep-disordered breathing (SDB) in women. METHODS: Within a population-based study, women with acute ischemic stroke were asked about their stroke symptom onset time. SDB screening was performed with the well-validated ApneaLink Plus device; SDB was defined by a respiratory event index ≥10. Logistic regression was used to test the association between SDB presence and severity and WUS unadjusted and adjusted for potential confounders including prestroke depression and sleep duration. RESULTS: Among 466 participants, the median age was 67.0 years (interquartile range [IQR] 58.0, 77.0), 55% were Mexican American, and the median initial NIH Stroke Scale score was 3.0 (IQR 1.0, 6.0). Stroke symptom onset occurred during nocturnal sleep (25.3%), during a nap (3.9%), during wakefulness (65.9%), or unknown (4.9%). In those with SDB screening performed (n = 259), a median of 11 days (IQR 5, 17) poststroke, WUS was not associated with the presence or severity (respiratory event index) of SDB in unadjusted or adjusted analysis. CONCLUSIONS: In this population-based study, WUS represented about 30% of all generally mild severity ischemic strokes in women and was not associated with SDB.
BACKGROUND: We sought to investigate the frequency of wake-up stroke (WUS) and its association with sleep-disordered breathing (SDB) in women. METHODS: Within a population-based study, women with acute ischemic stroke were asked about their stroke symptom onset time. SDB screening was performed with the well-validated ApneaLink Plus device; SDB was defined by a respiratory event index ≥10. Logistic regression was used to test the association between SDB presence and severity and WUS unadjusted and adjusted for potential confounders including prestroke depression and sleep duration. RESULTS: Among 466 participants, the median age was 67.0 years (interquartile range [IQR] 58.0, 77.0), 55% were Mexican American, and the median initial NIH Stroke Scale score was 3.0 (IQR 1.0, 6.0). Stroke symptom onset occurred during nocturnal sleep (25.3%), during a nap (3.9%), during wakefulness (65.9%), or unknown (4.9%). In those with SDB screening performed (n = 259), a median of 11 days (IQR 5, 17) poststroke, WUS was not associated with the presence or severity (respiratory event index) of SDB in unadjusted or adjusted analysis. CONCLUSIONS: In this population-based study, WUS represented about 30% of all generally mild severity ischemic strokes in women and was not associated with SDB.
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