Sleep-disordered breathing in patients with stroke-induced dysphagia.

Autor: Estai M; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; The Australian e-Health Research Centre, CSIRO, Perth, WA, Australia., Walsh J; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Maddison K; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Shepherd K; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Hillman D; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., McArdle N; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Baker V; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., King S; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Al-Obaidi Z; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Bamagoos A; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Physiology, Rabigh Medical School, King Abdulaziz University, Rabigh, Saudi Arabia., Parry R; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia., Langdon C; Department of Health & Human Services, Melbourne, Vic., Australia.; Department of Speech Pathology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Trzaskowski R; Department of Speech Pathology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Harris G; Department of Speech Pathology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Brookes K; Department of Speech Pathology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Blacker D; Department of Neurology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.; Perron Institute for Neurological and Translational Science, QEII Medical Centre, Nedlands, WA, Australia., Eastwood PR; Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia.; Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Jazyk: angličtina
Zdroj: Journal of sleep research [J Sleep Res] 2021 Jun; Vol. 30 (3), pp. e13179. Date of Electronic Publication: 2020 Aug 27.
DOI: 10.1111/jsr.13179
Abstrakt: This study examined the nature and characteristics of sleep-disordered breathing, including obstructive sleep apnea and central sleep apnea, in patients with post-stroke dysphagia, to determine the demographic, anthropometric and clinical variables that were associated with sleep-disordered breathing. Thirty-nine patients diagnosed with acute stroke (28 males and 11 females with a mean age of 72.3 ± 10.0 years) underwent overnight polysomnography (within 3.9 ± 1.6 days after admission). Sleep-disordered breathing was described by the apnea-hypopnea index and its obstructive and central components by the obstructive apnea-hypopnea index and central apnea-hypopnea index, respectively. Severity of dysphagia was assessed using the Mann Assessment of Swallowing Ability score. Severity of stroke and functional dependence were assessed by the National Institute of Health Stroke Scale and the modified Barthel index, respectively. Most of the cohort (87%) had moderate-to-severe dysphagia (Mann Assessment of Swallowing Ability of 143.2 ± 19.9). Sleep-disordered breathing (apnea-hypopnea index ≥ 5 events/hr) was present in 38 participants (97%) with a mean apnea-hypopnea index of 37.5 ± 24.4 events/hr. Sleep-disordered breathing was predominantly obstructive in nature, with a mean obstructive apnea-hypopnea index and central apnea-hypopnea index of 19.6 ± 15.7 and 11.4 ± 17.6 events/hr, respectively. Multivariate linear regression analyses showed that the apnea-hypopnea index was associated with sex (p = .0001), body mass index (p = .029) and the modified Barthel index (p = .006); the obstructive apnea-hypopnea index was associated with the Mann Assessment of Swallowing Ability (p = .006), sex (p = .004) and body mass index (p = .015) and had a nonlinear relationship with the modified Barthel index (p = .019); and the central apnea-hypopnea index was associated with sex (p = .027) and the modified Barthel index (p = .019). The present study showed that dysphagia severity was associated with obstructive sleep apnea severity and this association was independent of sex, modified Barthel index and body mass index. However, stroke-induced dysphagia was not associated with central sleep apnea or overall sleep-disordered breathing.
(© 2020 European Sleep Research Society.)
Databáze: MEDLINE
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