Figures
- FIGURE 1
Distribution of National Institutes of Health stroke scale (NIHSS) score at admission. a) Histogram; b) box and whisker plot.
- FIGURE 2
Correlations between a) baseline apnoea–hypopnoea index (AHI) and b) AHI at month 3, and admission National Institutes of Health stroke scale (NIHSS). Spearman rank correlation: a) ρ= −0.01, p=0.88; b) ρ=0.64, p<0.001.
- FIGURE 3
Evolution of sleep-disordered breathing (SDB) severity from the acute to the chronic stroke phase (M3). Overall, 104 patients were evaluable. The size of the arrows reflects the number of patients moving between categories (black: same; red: different category). BL: baseline; M3: follow-up after 3 months.
- FIGURE 4
Evolution of sleep-disordered breathing (SDB) type from baseline to 3 months (M3), individual changes in predominant type of SDB. Overall, 104 patients were evaluable. The size of the arrows reflects the number of patients moving between categories (black: same; red: different category). BL: baseline; M3: follow-up after 3 months; SA: sleep apnoea; OSA: obstructive sleep apnoea; CSA: central sleep apnoea. #: apnoea–hypopnoea index (AHI) <5·h−1; ¶: AHI >5·h−1.
Tables
- TABLE 1
Demographics, National Institutes of Health stroke scale (NIHSS) and stroke characteristics
PSG at baseline (n=166) PSG at both time points (n=105) Male 72% 79% BMI kg·m−2 27.7±4.9 27.0±4.9 Stroke 88.1% 92.4% Known arterial hypertension 55.6% 58.1% Current smoker 33.6% 29.5% Current atrial fibrillation 11.2% 9.5% Diabetes mellitus 14.7% 12.4% NIHSS at admission 4.3±5.1 4.0±4.5 NIHSS after 24 h 2.9±3.9 2.3±2.9 NIHSS at discharge 1.7±3.1 1.2±2.0 Stroke location LACI 13% 13% TACI 13% 6% PACI 44% 52% POCI 24% 25% No information 6 4 Infratentorial 23.7% 17.1% Data are presented as mean±sd unless otherwise stated. PSG: polysomnography; BMI: body mass index; LACI: lacunar infarction; TACI: total anterior circulation infarction; PACI: partial anterior circulation infarction; POCI: posterior circulation infarction.
- TABLE 2
Factors associated with baseline apnoea–hypopnoea index (ANCOVA)
Coefficient Standard error p-value Intercept −40.99 16.29 0.013 Age years 0.43 0.16 <0.001 Sex male 2.86 3.35 0.39 BMI kg·m−2 0.99 0.34 0.005 Admission NIHSS 0.24 0.30 0.44 Arteriole hypertension 3.96 3.22 0.22 Smoking >10 years 4.94 3.15 0.12 Time spent in supine position % 0.08 0.05 0.11 Time in bed h 0.21 0.93 0.83 Atrial fibrillation −1.32 4.92 0.79 Stroke on awakening or during sleep 0.69 3.19 0.83 diabetes mellitus 2.14 4.26 0.61 TOAST: large artery versus cardioembolic −0.523 5.65 0.93 TOAST: other/unknown versus cardioembolic −4.37 3.91 0.27 BMI: body mass index; NIHSS: National Institutes of Health stroke scale. Multiple R2=0.27, p<0.001 (F statistic 3.727 on 13 and 131 degrees of freedom).
- TABLE 3
Polysomnography data of patients included in the sleep-disordered breathing evolution analysis (n=105)
PSG parameter Baseline 3 months p-value TST h 5.3±1.5 (5.6) 5.8±1.4 (5.8) <0.01 Sleep efficiency % 58.9±18.2 (60.1) 66.8±17 (69.6) <0.001 WASO min 194±103.8 (167) 150.6±86.5 (124.5) <0.001 WASO % 36.6±17.3 (35.3) 29.6±15.8 (26.7) <0.001 N1 % 6.8±3.5 (6.2) 7.7±4.1 (7) 0.077 N2 % 27.9±9.8 (26.5) 31.9±10.9 (32.5) <0.001 N3 % 16.3±7.3 (16.8) 18.1±7.5 (18.1) 0.14 REM % 12±5.7 (11.8) 12.8±5.6 (12.7) 0.24 REM % TST 18.4±6.7 (18.4) 17.6±6.5 (17.6) 0.23 Arousal index events per h 24±12.2 (21.4) 23.3±11.1 (21.8) 0.96 Supine position % 37.2±28.7 (31.1) 44.5±30.9 (44.3) 0.073 AHI events per h 21.4±17,6 18±16.3 0.01 AHI during REM events per h 21.9±19,4 23.4±20,5 NS AHI during N1–N3 events per h 20,6±18,6 16.9±16.67 0.02 AHI in supine position events per h 32.7±28.5 27.5±24.5 NS OAI events per h (n=104) 6.3±9.9 3.8±6.7 0.009 CAI events per h (n=104) 2.7±7.5 1.8±5.6 NS MAI event per h (n=104) 1.5±4.4 (0.1) 0.6±1.7 (0) 0.04 Cheyne–Stokes breathing n (%) 26 (24.8) 18 (17.1) NS Mean SpO2 % 92.5±1.9 92.7±2.3 NS Lowest SpO2 % 86±4.79 85.3±5.69 NS SpO2 <90% % TST 10.2±22.2 10.9±23.4 NS ODI events per h 15.1±16 14±15.5 NS Data are presented as mean±sd (median) or mean±sd, unless otherwise stated. TST: total sleep time; WASO: wake after sleep onset. N: non-REM sleep; REM: rapid eye movement sleep; AHI: apnoea–hypopnoea index; OAI: obstructive apnoea index; CAI: central apnoea index; MAI: mixed apnoea index; SpO2: oxygen saturation measured by pulse oximetry; ODI: oxygen desaturation index.
- TABLE 4
Predictors of unfavourable neurological outcome (modified Rankin score >3) in logistic regression model (dichotomised modified Rankin 0–2 versus 3–6)
OR 95% CI p-value Age years 0.900 0.770–1.040 0.11 Sex male 0.377 0.038–3.718 0.53 BMI kg·m−2 0.904 0.719–1.138 0.24 Admission NIHSS 1.188 0.940–1.500 0.23 Hypertension 0.238 0.011–5.383 0.22 Atrial fibrillation 0.000 0.000–∞ 1.00 Stroke on awakening or during sleep (versus no or unknown) 15.699 0.726–339 0.10 Infratentorial stroke (versus other or unknown) 0.216 0.006–7.566 0.40 Cheyne–Stokes respiration 0 0–∞ 0.99 Baseline AHI 1.107 1.010–1.214 0.052 BMI: body mass index; NIHSS: National Institute of Health stroke scale; AHI: apnoea–hypopnoea index.
