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Sleep apnea common among stroke-related brainstem injuries

From the American Stroke Association

SAN DIEGO — People whose brainstems are affected by their stroke have a significantly higher prevalence of sleep apnea than those who have stroke-related injury elsewhere in the brain, according to University of Michigan Health System research presented at the American Stroke Association’s International Stroke Conference 2014.

Sleep apnea is marked by interrupted breathing during sleep and can lead to serious health problems including heart disease and stroke.

“This is the largest population-based study to address the issue of the location of the brain injury and its relationship to sleep apnea in post-stroke patients,” said Devin L. Brown, M.D., M.S., lead author of the study. She is an associate professor of neurology at the U-M Medical School and associate director of the U-M Stroke Program.

The 355 ischemic stroke patients, average 65 years and 55 percent men, who participated in the study, were drawn from those already enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) Project. Hispanics represented 59 percent of the study group; Non-Hispanic whites 35 percent; Native Americans 1 percent; and African-Americans 4 percent.

Patients were offered sleep apnea screening with a portable respiratory monitor and were screened about 13 days after their stroke.

Neurologists interpreted CT and MRI brain imaging scan results to determine if patients had brainstem involvement or no brainstem involvement in their stroke's effects.

Of the 11 percent of 355 stroke patients with brainstem injury, 84 percent had sleep apnea. Of those without brainstem involvement, 59 percent had sleep apnea.

Devin Brown, M.D., M.S.

“While these numbers are high, more research into the relationship between stroke and sleep apnea is needed before we recommend routine sleep apnea screening in post-stroke patients,” Brown said.

In the future, Brown said her group will continue to explore the relationship between sleep apnea and stroke.

Co-authors are Mollie McDermott, M.D.; Ashkan Mowia, M.D.; Ronald Chervin, M.D., M.S; Lewis Morgenstern, M.D.; Kevin Kerber, M.D.; Garnett Hegeman III, RPSGT; Melinda Smith, Dr.PH.; Nelda Garcia, B.S.; and Lynda Lisabeth, Ph.D. Author disclosures are on the abstract.

The National Institutes of Health funded the study.

Several members of the study team are members of the U-M Institute for Healthcare Policy and Innovation.

Study Abstract: Session A8, presentation 52, International Stroke Conference 2014

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