The Effect of Sleep Disordered Breathing on the Outcome of Stroke and Transient Ischemic Attack: a Systematic Review

Overview

Journal J Clin Sleep Med

Specialties Neurology
Psychiatry

Date 2014 Jan 16

PMID 24426829

Citations 39

Authors

Johannes Birkbak

Alice J Clark

Naja Hulvej Rod

Affiliations

Soon will be listed here.

Abstract

Study Objectives: The primary objective was to systematically review the literature on how sleep disordered breathing (SDB) affects recurrence and death among stroke or transient ischemic attack (TIA) patients. A secondary objective was to evaluate how treatment of SDB with continuous positive airway pressure (CPAP) affects the risk of recurrence and death in these patients.

Methods: Adults (18+) with a stroke or TIA diagnosis were eligible for inclusion. Case groups consisted of patients with a sleep disorder. The outcomes of interest were all-cause mortality, recurrent vascular events, and case fatality.

Results: Ten articles covering 1,203 stroke and TIA patients were included in the review. The results generally support a dose-response relationship between severity of SDB and risk of recurrent events and all-cause mortality in stroke and TIA patients. Three small-scale articles with substantial risk of bias evaluated the effects of CPAP therapy, and the results are inconclusive. Data on case fatality is too sparse to be conclusive.

Conclusions: Existing studies provide sufficient data to establish obstructive SDB as a negative predictor of all-cause mortality and recurrent vascular events following stroke or TIA. The ability of CPAP treatment to lower the risk of serious adverse outcomes after stroke remains controversial because of substantial risk of bias identified in most of the eligible studies addressing this relation. Additional studies are needed.

Citing Articles

Sleep Apnea and Stroke: A Narrative Review.

Dharmakulaseelan L, Boulos M Chest. 2024; 166(4):857-866.

PMID: 38815623 PMC: 11492226. DOI: 10.1016/j.chest.2024.04.028.

Sleep-Disordered Breathing and Prognosis after Ischemic Stroke: It Is Not Apnea-Hypopnea Index That Matters.

Korostovtseva L, Bochkarev M, Amelina V, Nikishkina U, Osipenko S, Vasilieva A Diagnostics (Basel). 2023; 13(13).

PMID: 37443640 PMC: 10340264. DOI: 10.3390/diagnostics13132246.

Positive airway pressure treatment for sleep-disordered breathing is rare during the first year after stroke: The BASIC project.

Schutz S, Lisabeth L, Kwicklis M, Case E, Chervin R, Brown D Sleep Med. 2023; 107:26-30.

PMID: 37099917 PMC: 10330335. DOI: 10.1016/j.sleep.2023.04.015.

Positive airway pressure therapy for post-stroke sleep disordered breathing: a systematic review, meta-analysis and meta-regression.

Toh Z, Cheng L, Wu X, De Silva D, Oh H, Ng S Eur Respir Rev. 2023; 32(167).

PMID: 36889784 PMC: 10032615. DOI: 10.1183/16000617.0169-2022.

Post-stroke sleep disturbance and recurrent cardiovascular and cerebrovascular events: A systematic review and meta-analysis.

Hale E, Gottlieb E, Usseglio J, Shechter A Sleep Med. 2023; 104:29-41.

PMID: 36889030 PMC: 10098455. DOI: 10.1016/j.sleep.2023.02.019.

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