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


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.


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



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)


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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

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