Original Articles
Prevalence of Sleep-Disordered Breathing in Patients With Acute Ischemic Stroke: Influence of Onset Time of Stroke
M.A. Martínez Garcíaa,
, R. Galiano Blancartb, L. Cabero Saltc, J.J. Soler Cataluñaa, T. Escamillac, P. Román Sánchezc
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med013413@nacom.es
Correspondence: Dr. M.A. Martínez García. Unidad de Neumología. Servicio de Medicina Interna. Hospital General de Requena. Paraje Casablanca, s/n. 46340 Requena. Valencia. España
Correspondence: Dr. M.A. Martínez García. Unidad de Neumología. Servicio de Medicina Interna. Hospital General de Requena. Paraje Casablanca, s/n. 46340 Requena. Valencia. España
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Galiano Blancart, L. Cabero Salt, J.J. Soler Cataluña, T. Escamilla, P. Román Sánchez" "autores" => array:6 [ 0 => array:5 [ "preGrado" => "Dr" "nombre" => "M.A." "apellidos" => "Martínez García" "email" => array:1 [ 0 => "med013413@nacom.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Galiano Blancart" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Cabero Salt" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "J.J." "apellidos" => "Soler Cataluña" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "T." "apellidos" => "Escamilla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 5 => array:3 [ "nombre" => "P." "apellidos" => "Román Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Neumología, Hospital General de Requena, Requena, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Neurología, Hospital General de Requena, Requena, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital General de Requena, Requena. Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. M.A. Martínez García. Unidad de Neumología. Servicio de Medicina Interna. Hospital General de Requena. Paraje Casablanca, s/n. 46340 Requena. Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-07-15" "fechaAceptado" => "2003-12-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153402" "palabras" => array:4 [ 0 => "Prevalence" 1 => "Sleep apnea-hypopnea syndrome" 2 => "Nighttime stroke" 3 => "Ischemic stroke" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153401" "palabras" => array:4 [ 0 => "Prevalencia" 1 => "Síndrome de apneas-hipopneas durante el sueño" 2 => "Ictus nocturno" 3 => "Ictus isquémico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO analyze the prevalence of sleep-disordered breathing in patients with acute ischemic stroke and the influence of the characteristics of the stroke and time of onset.</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Polysomnography was performed with an Autoset Portable Plus II in 139 patients within 72 hours of the onset of symptoms. Standard polysomnographic data, signs and symptoms related with sleep apnea-hypopnea syndrome (SAHS) prior to ischemic stroke, vascular risk factors, and characteristics and onset time (day/night) of ischemic stroke were recorded. The polysomnographic data were compared with results published for subjects of a similar age in the general population.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The mean age was 73.6 (SD 11.1) years (59% of the patients were men). Prior to the stroke, 64.7% of the patients snored, 21.6% presented repetitive sleep apneas, and 35.6% had daytime sleepiness. The mean apnea-hypopnea index (AHI) was 29.1 (17.9) episodes/hour, the obstructive component of which was 20.1 (15.7) episodes/hour. Five patients presented Cheyne-Stokes breathing. The AHI (for all cut-points from 5 to 50), chronic snoring, and daytime sleepiness were significantly greater than those published for the general population. The stroke characteristics showed no significant differences between daytime and nighttime onset. Nighttime stroke (60.4%) was associated with a significantly higher AHI (33.3 compared to 24.7 episodes/hour) mainly because of obstructive apneas. Nighttime stroke was also associated with a greater nighttime desaturation and a greater probability of SAHS symptoms prior to stroke (odds ratio, 2.62). In contrast, there were no differences in vascular risk factors between daytime and nighttime stroke onset.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalences of sleep-disordered breathing with clinical signs and symptoms of SAHS were high in this population of patients with acute ischemic stroke. Patients with nighttime stroke had more obstructive sleep-disordered breathing and a higher clinical probability of obstructive SAHS before stroke. These findings support the hypothesis that obstructive SAHS is a risk factor for ischemic stroke, particularly for strokes presenting at night.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar la prevalencia de trastornos respiratorios durante el sueño en pacientes con accidente cerebro-vascular isquémico agudo (ACVI) y la influencia de las ca-racterísticas y el momento de aparición del ictus.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se realizó una poligrafía respiratoria (Autoset Portable Plus II) en 139 pacientes con ACVI en las primeras 72 h desde el inicio de los síntomas. Se recogieron los datos poligráficos habituales, síntomas y signos relacionados con el síndrome de apnea-hipopneas del sueño (SAHS) previos al ACVI, factores de riesgo vascular y características y momento de aparición (diurno/nocturno) del ACVI. Los resultados poligráficos se compararon con los publicados para individuos de edad semejante de la población general.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La edad media (± desviación estándar) fue de 73,6 ± 11,1 años (el 59% eran varones). Antes del ictus, el 64,7% de los pacientes eran roncadores, el 21,6% presentaba apneas nocturnas repetidas y el 35,6%, somnolencia diurna. El índice medio de apneas-hipopneas fue de 29,1 ± 17,9, con un índice de apneas obstructivas de 20,1 ± 15,7. Cinco pacientes presentaron patrón de Cheyne-Stokes. El índice de apneas-hipopneas (para todos los puntos de corte estudiados; de 5 a 50), la roncopatía crónica y la hipersomnia diurna fueron significativamente mayores que los encontrados en población general. No hubo diferencias significativas según las características del ACVI. Los ACVI nocturnos (60,4%) mostraron de forma significativa un mayor índice de apneas-hipopneas (33,3 frente a 24,7) a cargo fundamentalmente de las apneas de carácter obstructivo, así como una mayor desaturación nocturna y una mayor probabilidad clínica de presencia de SAHS antes del ictus (<span class="elsevierStyleItalic">odds ratio</span> de 2,62). No hubo, sin embargo, diferencias con res-pecto a los factores de riesgo vascular estudiados.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p class="elsevierStyleSimplePara elsevierViewall">En nuestra serie hubo una alta prevalencia de trastornos respiratorios durante el sueño y de clínica relacionada con SAHS en pacientes con ACVI agudo. Los ictus nocturnos presentaron un mayor número de trastornos respiratorios del sueño de carácter obstructivo y una mayor probabilidad clínica de SAHS previo. Nuestro estudio apoya la hipótesis de un SAHS obstructivo previo al ictus que podría funcionar como factor de riesgo, sobre todo en las formas de aparición nocturna.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective study of the association between sleep-disordered breathing and hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "PE Peppard" 1 => "T Young" 2 => "M Palta" 3 => "J Skatrud" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM200005113421901" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2000" "volumen" => "342" "paginaInicial" => "1378" "paginaFinal" => "1384" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10805822" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of sleep apnea, and hypertension in a large community-based study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "FJ Nieto" 1 => "T Young" 2 => "BK Lind" 3 => "E Shahar" 4 => "JM Samet" 5 => "S Redline" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2000" "volumen" => "283" "paginaInicial" => "1829" "paginaFinal" => "1836" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10770144" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sleep apnea and cardiovascular disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "RST Leung" 1 => "D Bradley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.164.12.2107045" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2001" "volumen" => "164" "paginaInicial" => "2147" "paginaFinal" => "2165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11751180" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sleep-disordered breathing and cardiovascular disease. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 1 | 6 |
| 2024 October | 28 | 13 | 41 |
| 2024 September | 21 | 12 | 33 |
| 2024 August | 38 | 30 | 68 |
| 2024 July | 25 | 18 | 43 |
| 2024 June | 27 | 22 | 49 |
| 2024 May | 29 | 26 | 55 |
| 2024 April | 12 | 21 | 33 |
| 2024 March | 19 | 12 | 31 |
| 2024 February | 12 | 18 | 30 |
| 2023 March | 4 | 6 | 10 |
| 2023 February | 14 | 11 | 25 |
| 2023 January | 15 | 34 | 49 |
| 2022 December | 16 | 18 | 34 |
| 2022 November | 19 | 21 | 40 |
| 2022 October | 15 | 23 | 38 |
| 2022 September | 12 | 23 | 35 |
| 2022 August | 18 | 36 | 54 |
| 2022 July | 10 | 28 | 38 |
| 2022 June | 12 | 27 | 39 |
| 2022 May | 12 | 26 | 38 |
| 2022 April | 14 | 37 | 51 |
| 2022 March | 14 | 27 | 41 |
| 2022 February | 11 | 22 | 33 |
| 2022 January | 11 | 23 | 34 |
| 2021 December | 12 | 38 | 50 |
| 2021 November | 13 | 35 | 48 |
| 2021 October | 13 | 40 | 53 |
| 2021 September | 16 | 47 | 63 |
| 2021 August | 11 | 32 | 43 |
| 2021 July | 12 | 26 | 38 |
| 2021 June | 12 | 35 | 47 |
| 2021 May | 15 | 20 | 35 |
| 2021 April | 40 | 58 | 98 |
| 2021 March | 17 | 21 | 38 |
| 2021 February | 14 | 14 | 28 |
| 2021 January | 8 | 11 | 19 |
| 2020 December | 10 | 18 | 28 |
| 2020 November | 11 | 9 | 20 |
| 2020 October | 21 | 7 | 28 |
| 2020 September | 24 | 3 | 27 |
| 2020 August | 10 | 8 | 18 |
| 2020 July | 16 | 16 | 32 |
| 2020 June | 18 | 6 | 24 |
| 2020 May | 24 | 15 | 39 |
| 2020 April | 19 | 12 | 31 |
| 2020 March | 12 | 11 | 23 |
| 2020 February | 24 | 19 | 43 |
| 2020 January | 12 | 14 | 26 |
| 2019 December | 11 | 17 | 28 |
| 2019 November | 16 | 9 | 25 |
| 2019 October | 8 | 15 | 23 |
| 2019 September | 15 | 13 | 28 |
| 2019 August | 9 | 6 | 15 |
| 2019 July | 8 | 15 | 23 |
| 2019 June | 7 | 4 | 11 |
| 2019 May | 16 | 17 | 33 |
| 2019 April | 62 | 21 | 83 |
| 2019 March | 18 | 12 | 30 |
| 2019 February | 8 | 10 | 18 |
| 2019 January | 5 | 10 | 15 |
| 2018 December | 9 | 9 | 18 |
| 2018 November | 21 | 8 | 29 |
| 2018 October | 39 | 11 | 50 |
| 2018 September | 11 | 10 | 21 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 5 | 5 | 10 |
| 2018 March | 7 | 4 | 11 |
| 2018 February | 4 | 11 | 15 |
| 2018 January | 4 | 4 | 8 |
| 2017 December | 3 | 6 | 9 |
| 2017 November | 6 | 3 | 9 |
| 2017 October | 10 | 10 | 20 |
| 2017 September | 5 | 11 | 16 |
| 2017 August | 13 | 9 | 22 |
| 2017 July | 11 | 5 | 16 |
| 2017 June | 8 | 8 | 16 |
| 2017 May | 13 | 6 | 19 |
| 2017 April | 3 | 4 | 7 |
| 2017 March | 17 | 3 | 20 |
| 2017 February | 4 | 3 | 7 |
| 2017 January | 4 | 3 | 7 |
| 2016 December | 11 | 7 | 18 |
| 2016 November | 19 | 12 | 31 |
| 2016 October | 13 | 8 | 21 |
| 2016 September | 5 | 4 | 9 |
| 2016 August | 7 | 5 | 12 |
| 2016 July | 7 | 6 | 13 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 33 | 1 | 34 |
| 2015 September | 43 | 15 | 58 |
| 2015 August | 26 | 7 | 33 |
| 2015 July | 49 | 8 | 57 |
| 2015 June | 35 | 7 | 42 |
| 2015 May | 35 | 18 | 53 |
| 2015 April | 29 | 7 | 36 |
| 2015 March | 30 | 9 | 39 |
| 2015 February | 26 | 2 | 28 |
| 2015 January | 24 | 11 | 35 |
| 2014 December | 28 | 6 | 34 |
| 2014 November | 41 | 6 | 47 |
| 2014 October | 72 | 8 | 80 |
| 2014 September | 39 | 3 | 42 |
| 2014 August | 32 | 14 | 46 |
| 2014 July | 31 | 5 | 36 |
| 2014 June | 41 | 7 | 48 |
| 2014 May | 49 | 9 | 58 |
| 2014 April | 53 | 5 | 58 |
| 2014 March | 66 | 11 | 77 |
| 2014 February | 40 | 12 | 52 |
| 2014 January | 38 | 7 | 45 |
| 2013 December | 43 | 10 | 53 |
| 2013 November | 39 | 7 | 46 |
| 2013 October | 36 | 6 | 42 |
| 2013 September | 40 | 10 | 50 |
| 2013 August | 35 | 9 | 44 |
| 2013 July | 40 | 25 | 65 |
| 2013 June | 30 | 5 | 35 |
| 2013 May | 29 | 9 | 38 |
| 2013 April | 26 | 3 | 29 |
| 2013 March | 10 | 1 | 11 |
Show all
