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Sleep Apnea Impairs Function in Stroke Patients: Presented at AHA

By Jill Stein

Special to DG News

ANAHEIM, CA -- November 12, 2001-- The presence of sleep apnea appears to worsen the functional outcomes in stroke patients.

Dr. Yasuyuki Kaneko and colleagues from University of Toronto, in Toronto, Ontario, Canada, conducted sleep studies in 58 consecutive stroke patients admitted to their rehabilitation unit.

They presented their findings yesterday (Nov. 11) at the 74th annual scientific sessions of the American Heart Association (AHA), in Anaheim, California.

Researchers defined sleep apnea as an apnea-hypopnea index of at least 10 events per hour.

Patients also underwent functional and cognitive evaluations at study admission, including the Functional Independence Measure (FIM) and Mini-Mental Status Exam (MMSE).

"Functional and mental disability are frequent sequelae of strokes and necessitate prolonged hospitalization," Dr. Kaneko explained. Sleep apnea, he added, might have adverse effects on brain function due to cerebral hypoxia and hypoperfusion, fragmentation of sleep, and hypertension, and may therefore predispose to strokes and/or aggravate functional and mental disability in stroke patients.

Sleep apnea, which was found in 42 (72 percent) patients, was associated with worse FIM results but not with worse MMSE results. Patients with sleep apnea were also found to spend more days in the hospital -- 52 days in patients without sleep apnea and 67 days in patients with sleep apnea.

An inverse association was documented between the severity of sleep apnea and functional impairment. At the same time, a direct relationship was found between the apnea-hypopnea index and duration of hospitalization.

There was no association between sleep apnea and the type or territory of stroke.

Dr. Kaneko said the results indicate that sleep apnea, especially obstructive sleep apnea, is extremely common in stroke patients and tends to worsen functional but not cognitive impairment. Treatment of obstructive apnea in stroke patients may help improve functional outcome and shorten hospital stay.

The data suggest that sleep apnea may impair recovery from stroke, possibly due to recurrent cerebral hypoxia and fragmentation of sleep, he noted.

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