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Sleep Apnoea Linked To Multiple Mental Disorders After Stroke

Sleep apnoea, which is common in stroke patients, is associated with delirium, depression, slow reactions and responses to verbal stimuli, and impaired ability to carry out activities of daily living.

A trial is needed to see if nasal continuous positive airway pressure treatment of sleep apnoea improve these conditions, say investigators at Umeå University, Umeå, Sweden.

They carried out a study among 78 women and 55 men, aged 77.1±7.7 years who had been consecutively admitted to a geriatric stroke rehabilitation unit.

All patients underwent overnight respiratory sleep recordings 11 to 41 days after having a stroke. They were assessed using the Organic Brain Syndrome Scale, the Montgomery-Åsberg-Depression-Rating Scale, the Mini-Mental State Examination, and the Barthel-ADL Index.

Of the 133 patients, 59 percent fulfilled the criterion of sleep apnoea-an apnoea-hypopnoea index of 10 or more (median 13, range 0-79) -and 52 percent with first-ever stroke had sleep apnoea.

More patients with sleep apnoea were delirious, depressed or less able to carry out activities of daily living than patients who did not have sleep apnoea. Patients with apnoea also had more ischaemic heart disease and earlier cerebral infarction.

Statistical analysis showed that obesity, low activities of daily living scores, ischaemic heart disease and depressed mood were independently associated with sleep apnoea.

Low activities of daily living scores, related-related hypoxaemia, body mass index of 27 or less and impaired vision were independently associated with delirium.

Sleep apnoea was not associated with any particular type of stroke or location of the brain lesion.
Journal of the American Geriatrics Society 2001; 49 (4): 391-397. "Sleep Apnea, Delirium, Depressed Mood, Cognition, and ADL Ability After Stroke"

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