Sebastian Zaremba1,2, Luca Albus3, Hartmut Vatter4, Thomas Klockgether3, Erdem Güresir4. 1. Department of Neurology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany. sebastian.zaremba@seeklinik-brunnen.ch. 2. Department of Sleep Medicine, Seeklinik Brunnen, Gersaustrasse 8, 6440, Brunnen-Ingenbohl, Switzerland. sebastian.zaremba@seeklinik-brunnen.ch. 3. Department of Neurology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany. 4. Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
Abstract
RATIONALE: Retrospective studies indicate that obstructive sleep apnea occurs often after aneurysmal subarachnoid hemorrhage. We aim to investigate if obstructive sleep apnea is associated with impaired blood pressure control early after subarachnoid hemorrhage. METHODS: Patients with subarachnoid hemorrhage were recruited and screened for sleep apnea using cardiorespiratory polygraphy within 48 h after intensive care unit admission, and 6 months after hospital discharge at home. Blood pressure was continuously measured using intra-arterial catheter within the first 24 h after admission. Time between hospital admission and first blood pressure below 140 mmHg, and time with elevated blood pressure within the first 24 h after admission were compared between patients with and without obstructive sleep apnea. RESULTS: Of 60 patients, 55 successfully completed the study. Obstructive sleep apnea (AHI > 5/h) was diagnosed in 32% of men and 24% of women. While the time to reach a blood pressure of 140 mmHg did not differ (60.0 ± 26.2 min vs. 49.7 ± 16.4 min; p = 0.74), obstructive sleep apnea patients spent more time with blood pressure above 140 mmHg (292.0 ± 114.0 vs. 96.9 ± 28.3 min per 24 h; p = 0.025, CI 95 -363.6 to -26.5) within the observational period. Only AHI and diagnosed hypertension were significant predictors for elevated blood pressure (R2 0.42; p = 0.03). CONCLUSION: Obstructive sleep apnea is associated in our study with poor blood pressure control early after subarachnoid hemorrhage. These patients may need advanced management for blood pressure including management for OSA following subarachnoid hemorrhage. Screening for sleep apnea in patients with subarachnoid hemorrhage is recommended. TRIAL REGISTRATION: ClincalTrials.gov identifier: NCT02724215, registered on March 31, 2016.
RATIONALE: Retrospective studies indicate that obstructive sleep apnea occurs often after aneurysmal subarachnoid hemorrhage. We aim to investigate if obstructive sleep apnea is associated with impaired blood pressure control early after subarachnoid hemorrhage. METHODS: Patients with subarachnoid hemorrhage were recruited and screened for sleep apnea using cardiorespiratory polygraphy within 48 h after intensive care unit admission, and 6 months after hospital discharge at home. Blood pressure was continuously measured using intra-arterial catheter within the first 24 h after admission. Time between hospital admission and first blood pressure below 140 mmHg, and time with elevated blood pressure within the first 24 h after admission were compared between patients with and without obstructive sleep apnea. RESULTS: Of 60 patients, 55 successfully completed the study. Obstructive sleep apnea (AHI > 5/h) was diagnosed in 32% of men and 24% of women. While the time to reach a blood pressure of 140 mmHg did not differ (60.0 ± 26.2 min vs. 49.7 ± 16.4 min; p = 0.74), obstructive sleep apnea patients spent more time with blood pressure above 140 mmHg (292.0 ± 114.0 vs. 96.9 ± 28.3 min per 24 h; p = 0.025, CI 95 -363.6 to -26.5) within the observational period. Only AHI and diagnosed hypertension were significant predictors for elevated blood pressure (R2 0.42; p = 0.03). CONCLUSION: Obstructive sleep apnea is associated in our study with poor blood pressure control early after subarachnoid hemorrhage. These patients may need advanced management for blood pressure including management for OSA following subarachnoid hemorrhage. Screening for sleep apnea in patients with subarachnoid hemorrhage is recommended. TRIAL REGISTRATION: ClincalTrials.gov identifier: NCT02724215, registered on March 31, 2016.
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