Advertisement

Journal of Neurology

, Volume 265, Issue 6, pp 1288–1294 | Cite as

Wake-up stroke and sleep-disordered breathing: a meta-analysis of current studies

  • Zijian Xiao
  • Ming Xie
  • Yong You
  • Heng Wu
  • Guijuan Zhou
  • Mingyong Li
Original Communication
  • 148 Downloads

Abstract

Sleep-disordered breathing (SDB) is a frequent comorbidity in patients with wake-up stroke (WUS). It affects the occurrence of this disease through its interference of breathing changes and sleep quality. We aim to assess the performances of sleep-disordered breathing in WUS. A systematical search for the studies that investigated sleep-disordered breathing in WUS was done in PubMed, Web of Science, and Cochrane Library. Data were extracted by two independent investigators, and then analyzed using the Revman 5.0 software. A total of five studies with 591 patients were included in the meta-analysis. The pooling data of sleep parameters showed that patients with WUS had a higher AHI and ODI than those with non-WUS (NWUS) [AHI: SMD: 0.58 (0.05, 1.10), P = 0.03; ODI: SMD: 0.63 (0.06, 1.21), P = 0.03). In addition, an increased incidence of severe SAS is found in WUS (OR: 3.18; 95% CI 1.27, 7.93; P = 0.01). However, no differences were found in AI, ESS, and the number of sleep apnea syndrome (SAS) between the two groups (P > 0.05). Therefore, WUS patients intended to have a severe SDB status, affecting the respiratory effects. Early prevention and attention should be paid on potential stroke sufferers with SAS, especially those with severe SAS.

Keywords

Wake-up stroke Non-wake-up stroke Sleep-disordered breathing Respiratory Meta-analysis 

Notes

Acknowledgements

This study was supported by grants from the National Natural Science Foundation of China (Grant No. 81401190) and Natural Science Foundation of Hunan Province (Grant No. 2017JJ3273).

Compliance with ethical standards

Conflicts of interest

There was no conflict of interests among the authors.

Ethical standards

The manuscript does not contain clinical studies or patient data.

Supplementary material

415_2018_8810_MOESM1_ESM.jpg (224 kb)
Supplementary Figure 1. Meta-analysis of ESS. WUS wake-up stroke, NWUS non-WUS, ESS Epworth Sleepiness Scale (JPEG 223 kb)
415_2018_8810_MOESM2_ESM.jpg (184 kb)
Supplementary Figure 2. Meta-analysis of SAS. WUS wake-up stroke, NWUS non-WUS, SAS sleep apnea syndrome (JPEG 184 kb)
415_2018_8810_MOESM3_ESM.docx (13 kb)
Supplementary material 3 (DOCX 13 kb)

References

  1. 1.
    Rubin MN, Barrett KM (2015) What to do with wake-up stroke. Neurohospitalist 5(3):161–172CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Kim TJ, Ko SB, Jeong HG, Lee JS, Kim CK, Kim Y, Nam K, Mo H, Joon AS, Choi HA, Yoon BW (2016) Nocturnal desaturation in the stroke unit is associated with wake-up ischemic stroke. Stroke 47(7):1748–1753CrossRefPubMedGoogle Scholar
  3. 3.
    Sharma S, Culebras A (2016) Sleep apnoea and stroke. Stroke Vasc Neurol 1(4):185–191CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Tsai JP, Albers GW (2017) Wake-up stroke: current understanding. Top Magn Reson Imaging 26(3):97–102CrossRefPubMedGoogle Scholar
  5. 5.
    Lombardi C, Tobaldini E, Montano N, Losurdo A, Parati G (2017) Obstructive sleep apnea syndrome (OSAS) and cardiovascular system. Med Lav 108(4):276–282PubMedGoogle Scholar
  6. 6.
    Panic N, Leoncini E, de Belvis G, Ricciardi W, Boccia S (2013) Evaluation of the endorsement of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement on the quality of published systematic review and meta-analyses. PLoS One 8(12):e83138CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) Group. JAMA 283(15):2008–2012CrossRefPubMedGoogle Scholar
  8. 8.
    Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson WS, Tangredi MM (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American Academy of Sleep Medicine. J Clin Sleep Med 8(5):597–619PubMedPubMedCentralGoogle Scholar
  9. 9.
    Omachi TA (2011) Measures of sleep in rheumatologic diseases: Epworth Sleepiness Scale (ESS), Functional Outcome of Sleep Questionnaire (FOSQ), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). Arthritis Care Res (Hoboken) 63(Suppl 11):S287–S296CrossRefPubMedCentralGoogle Scholar
  10. 10.
    Margulis AV, Pladevall M, Riera-Guardia N, Varas-Lorenzo C, Hazell L, Berkman ND, Viswanathan M, Perez-Gutthann S (2014) Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: the Newcastle-Ottawa Scale and the RTI item bank. Clin Epidemiol 6:359–368CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hsieh SW, Lai CL, Liu CK, Hsieh CF, Hsu CY (2012) Obstructive sleep apnea linked to wake-up strokes. J Neurol 259(7):1433–1439CrossRefPubMedGoogle Scholar
  12. 12.
    Siarnik P, Kollar B, Carnicka Z, Surda P, Klobucnikova K, Sykora M, Turcani P (2016) Association of sleep disordered breathing with wake-up acute ischemic stroke: A Full Polysomnographic Study. J Clin Sleep Med 12(4):549–554CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Koo BB, Bravata DM, Tobias LA, Mackey JS, Miech EJ, Matthias MS, Stahl SM, Sico JJ, Vaz FC, Williams LS, Lampert R, Qin L, Yaggi HK (2016) Observational Study of obstructive sleep apnea in wake-up stroke: The SLEEP TIGHT Study. Cerebrovasc Dis 41(5–6):233–241CrossRefPubMedGoogle Scholar
  14. 14.
    Diniz DL, Barreto PR, Bruin PF, Bruin VM (2016) Wake-up stroke: clinical characteristics, sedentary lifestyle, and daytime sleepiness. Rev Assoc Med Bras (1992) 62(7):628–634CrossRefGoogle Scholar
  15. 15.
    Fink JN, Kumar S, Horkan C, Linfante I, Selim MH, Caplan LR, Schlaug G (2002) The stroke patient who woke up: clinical and radiological features, including diffusion and perfusion MRI. Stroke 33(4):988–993CrossRefPubMedGoogle Scholar
  16. 16.
    Stern GM, Van Hise N, Urben LM, Korobey MJ, Pitlick JM, Crannage AJ (2017) Thrombolytic therapy in wake-up stroke patients. Clin Neuropharmacol 40(3):140–146CrossRefPubMedGoogle Scholar
  17. 17.
    Lutohin GM, Geraskina LA, Fonyakin AV (2016) Sleep-disordered breathing syndrome in acute ischemic stroke. Zh Nevrol Psikhiatr Im S S Korsakova 116(12):14–20CrossRefPubMedGoogle Scholar
  18. 18.
    Hermann DM, Bassetti CL (2003) Sleep-disordered breathing and stroke. Curr Opin Neurol 16(1):87–90CrossRefPubMedGoogle Scholar
  19. 19.
    Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342(19):1378–1384CrossRefPubMedGoogle Scholar
  20. 20.
    Tauman R, Ivanenko A, O’Brien LM, Gozal D (2004) Plasma C-reactive protein levels among children with sleep-disordered breathing. Pediatrics 113(6):e564–e569CrossRefPubMedGoogle Scholar
  21. 21.
    Ruehland WR, Rochford PD, O’Donoghue FJ, Pierce RJ, Singh P, Thornton AT (2009) The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. Sleep 32(2):150–157CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Chung F, Liao P, Elsaid H, Islam S, Shapiro CM, Sun Y (2012) Oxygen desaturation index from nocturnal oximetry: a sensitive and specific tool to detect sleep-disordered breathing in surgical patients. Anesth Analg 114(5):993–1000CrossRefPubMedGoogle Scholar
  23. 23.
    Sterne JA, Gavaghan D, Egger M (2000) Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol 53(11):1119–1129CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The First Affiliated Hospital of University of South ChinaUniversity of South ChinaHengyangChina

Personalised recommendations