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Sleep-related breathing disorders in acute lacunar stroke

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Abstract

The purpose was to examine the occurrence of sleep-related breathing disorders (SRBD) and variables related to SRBD in patients with acute lacunar stroke. In 68 consecutive patients with radiologically proven lacunes, respiratory polygraphy within the first 48 h of stroke onset was performed. SRBDs were classified according to mutually exclusive cutoff values of the apnea/hypopnea index (AHI) as mild (AHI ≥10), moderate (AHI ≥20), and severe (AHI ≥30). Variables independently associated with SRBDs were assessed by logistic regression analysis. The mean (standard deviation) AHI was 21.9 (17.4). A total of 69.1% of patients showed AHI ≥10, 44.1% AHI ≥20, and 25% AHI ≥30. Cheyne-Stokes respiration (CSR) was present in 20.6% of patients. Smoking (>20 cigarettes/day) or location of lacunes in the internal capsule or the pons was significantly more frequent in the AHI ≥10 group than in the remaining AHI groups (80.9% vs. 57.1%, P = 0.041). AHI ≥20 and AHI ≥30 occurred more frequently in smokers or in capsular or pontine lacunes than in the remaining patients (20% vs. 2.6%, P = 0.053; 29.4% vs. 3.9%, P = 0.01, respectively). In the multivariate analysis, smoking or capsular or pontine topographies were associated with AHI ≥10 [odds ratio (OR) = 3.17, 95% confidence interval (CI) 1.02–9.79; P = 0.045]. Lacunes in the internal capsule or the pons in smokers were associated with AHI ≥20 (OR = 9.25, 95% CI 1.05–81.70; P = 0.045). Smoking (OR = 19.64, 95% CI 1.68–229.85; P = 0.010) and body mass index (OR = 1.68, 95% CI 1.13–2.50; P = 0.010) were associated with AHI ≥30. Smoker patients with capsular or pontine acute lacunar stroke should be screened for SRDB.

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Acknowledgments

The authors thank Marta Pulido, MD, for editing the manuscript and for editorial assistance. The first-author credit should be equally distributed among M. Bonnin-Vilaplana, A. Arboix, and O. Parra. This study was supported by a grant from FIS PI081514.

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None declared.

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Authors and Affiliations

  1. The Service of Pneumology, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, Spain

    Marc Bonnin-Vilaplana & Olga Parra

  2. Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Viladomat 288, E-08029, Barcelona, Spain

    Adrià Arboix & Joan Massons

  3. CIBER de Enfermedades Respiratorias (CB06/06), Instituto Carlos III, Madrid, Spain

    Adrià Arboix, Olga Parra & Josep M. Montserrat

  4. Unidad de Organización, Planificación y Sistemas de Información, Consorci Sanitari del Maresme Mataró, Barcelona, Spain

    Luis García-Eroles

  5. Sleep Unit, Service of Pneumology, Hospital Clínic Provincial, Department of Medicine, Universitat de Barcelona, Barcelona, Spain

    Josep M. Montserrat

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  1. Marc Bonnin-Vilaplana
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  2. Adrià Arboix
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Correspondence to Adrià Arboix.

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Bonnin-Vilaplana, M., Arboix, A., Parra, O. et al. Sleep-related breathing disorders in acute lacunar stroke. J Neurol 256, 2036–2042 (2009). https://doi.org/10.1007/s00415-009-5236-x

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