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Hospitalised Stroke Patients Should Be Screened for Sleep Apnea: Presented at AAN

By Jill Stein

SAN FRANCISCO, CA -- April 27, 2004 -- Patients admitted to the hospital with an acute ischaemic stroke should be screened for sleep apnoea using the Berlin questionnaire, researchers said here on April 27^th at the 56^th Annual Meeting of the American Academy of Neurology.

The Berlin questionnaire is a validated screening tool for identifying patients at risk for sleep apnoea in the primary care setting. The questionnaire assesses habitual snoring, daytime sleepiness, hypertension, and body mass index. Respondents are classified as being at high or low risk for sleep apnoea.

Sylvia Zuniga, MD, Department of Neurology, University of Miami School of Medicine, Miami, Florida, and colleagues analysed the results obtained from 122 patients who were hospitalised with an acute ischaemic stroke during a recent 10-month period and who responded to the Berlin questionnaire.

The stroke mechanism included cardioembolism in 19% of patients, large vessel atherosclerosis in 29%, and small vessel occlusion in 33%. Stroke mechanism was undetermined in 13% of patients, and other causes were responsible in 6%.

In the trial, a high apnoea risk was identified by any two of the three following categories:

Category 1 - patients who snored louder than they talked, who snored at least 3 to 4 times a week, whose snoring resulted in complaints by others, and whose breathing was marked by pauses at least 3 to 4 times a week.

Category 2 - patients who had early morning and daytime fatigue more than three to four times a week or who fell asleep while driving.

Category 3 - patients who were hypertensive or whose body mass index exceeded 30 kg/m².

Results showed that among the 122 patients who were hospitalised with an acute ischaemic stroke, 55% were at high risk for sleep apnoea.

"The high prevalence of sleep apnoea in stroke patients places the treating neurologist in a unique position to identify high risk patients for more effective management," Dr. Zuniga said. "However, a sleep history is infrequently obtained during admission to general medical wards."

The results show that a tool like the Berlin questionnaire, which can be easily administered, can readily identify high-risk patients, she added.


[Presentation title: Screening for Sleep Apnea during Hospitalization for Acute Ischemic Stroke. P01.091.]

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