Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up
2008 (English)In: Archives of Internal Medicine, ISSN 0003-9926, E-ISSN 1538-3679, Vol. 168, no 3, 297-301 p.Article in journal (Refereed) Published
Background: Sleep apnea occurs frequently among stroke patients, but it is still unknown whether a diagnosis of sleep apnea is an independent risk factor for mortality. We aimed to investigate whether obstructive or central sleep apnea was related to a reduced long-term survival among stroke patients.
Methods: One hundred and thirty-two of 151 patients admitted for in-hospital stroke rehabilitation in the catchment area of Umeå from 1 April 1995 to 1 May 1997 underwent overnight sleep apnea recordings at 23 ± 8 days after onset of stroke. All patients were followed-up prospectively for a mean (SD) of 10.0 ± 0.6 years, with death as the primary outcome and no one was lost to follow-up. Obstructive sleep apnea was defined when the obstructive apnea-hypopnea index was over 15 and central sleep apnea when the central apnea-hypopnea index was over 15. Patients with an obstructive and a central apnea-hypopnea index below 15 served as controls.
Results: Of 132 enrolled patients, 116 had died at follow-up. The risk of death was higher among the 23 patients with obstructive sleep apnea than controls (adjusted hazard ratio, 1.76; 95% confidence interval 1.05 to 2.95, p=0.03), independent of age, gender, body-mass index, smoking, hypertension, diabetes mellitus, atrial fibrillation, mini-mental state examination and Barthel activity of daily living There was no difference in mortality between the 28 patients with central sleep apnea and controls (adjusted hazard ratio, 1.07; 95 percent confidence interval 0.65 to 1.76, p=0.053).
Conclusions: Stroke patients with obstructive sleep apnea run an increased risk of early death. Central sleep apnea was not related to early death among the present patients.
Place, publisher, year, edition, pages
Chicago: American medical association , 2008. Vol. 168, no 3, 297-301 p.
obstructive sleep apnéa, stroke, death, positive airway pressure, Cheyne-Stokes respiration, breathing disorders, ischemic stroke, 1st-ever stroke, prognosis, disease, night
Cardiac and Cardiovascular Systems Family Medicine
Research subject Lung Medicine
IdentifiersURN: urn:nbn:se:umu:diva-18814DOI: 10.1001/archinternmed.2007.70ISI: 000252962300009OAI: oai:DiVA.org:umu-18814DiVA: diva2:174854