A1 Journal article – refereed

Wake-up strokes are linked to obstructive sleep apnea and worse early functional outcome

List of Authors: Haula Tuuli-Maria, Puustinen Juha, Takala Mari, Holm Anu

Publisher: WILEY

Publication year: 2021

Journal: Brain and Behavior

Journal name in source: BRAIN AND BEHAVIOR

Journal acronym: BRAIN BEHAV

Volume number: 11

Issue number: 8

Number of pages: 8

ISSN: 2162-3279

eISSN: 2162-3279

DOI: http://dx.doi.org/10.1002/brb3.2284


Background and Aims: Presence of sleep-disordered breathing (SDB) and especially obstructive sleep apnea (OSA) is a known risk factor for ischemic stroke. Additionally, SDB effects negatively on recovery after stroke. Up to one fourth of strokes are present on awakening. The link between OSA and wake-up stroke (WUS) has been suggested. We aim to determine the association between OSA and WUS in a Finnish stroke unit cohort.

Material and Methods: An observational prospective longitudinal study consisted of 95 TIA (transient ischemic attack) and mild to moderate stroke patients referred to a Stroke Unit in Finland. Respiratory polygraphy was performed within 72 h of hospital admission. Patients were classified into WUS and non-WUS, and functional outcome measures (mRS, rehabilitation, hospitalization time) were collected. Functional outcomes and prevalence of OSA were compared between non-WUS and WUS.

Results: OSA (AHI > 15/h) was more frequent among WUS than non-WUS (71% and 36%, respectively, p = 0.009). Functional outcome measured with mRS was worse in patients with WUS than non-WUS on registration day and at hospital discharge (p = 0.001). Need for rehabilitation in WUS was 43% of cases compared to 23% of non-WUS (p = 0.067). Hospitalization time was longer (5-15days) in 55% of WUS and 41% of non-WUS patients (p = 0.261).

Conclusion: Moderate-to-severe OSA is related to WUS compared to non-WUS. In addition, WUS have worse short-term outcomes measured in mRS. Further studies are needed to determine if OSA is causally linked to WUS.

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Last updated on 2021-27-09 at 13:09