2011 Volume 33 Issue 5 Pages 488-494
Sleep-disordered breathing (SBD) has been reported to be a risk factor for cerebrovascular disease. We investigated the frequency of SDB in Japanese patients with acute cerebrovascular disease and the associated factors. Between May 2010 and January 2011, we prospectively enrolled 140 patients (85 males; mean age, 72.6 years) with cerebrovascular disease within 24 hours of onset and evaluated SBD within 7 days after admission. SBD was defined as respiratory disturbance index (RDI) ≥ 5. Patients were divided into 4 groups according to the RDI value as follows: < 5 (none), 5-14 (mild), 15-29 (moderate), and ≥ 30 (severe), and the factors associated with SDB were investigated. The mean time from admission to the sleep study was 4.6 days. The mean RDI was 23.8±18.2. SDB was observed in 125 patients (89%). Frequencies of SDB by cerebrovascular disease type were as follows: 17/20 patients (85%) with TIA, 83/94 patients (88%) with ischemic stroke [7/7 patients (100%) with large artery atherosclerosis, 12/12 patients (100%) with small vessel occlusion, 30/33 patients (91%) with cardioembolism, 34/42 patients (81%) with other/undetermined causes of stroke], and 25/26 patients (96%) with intracerebral hemorrhage. The percentage of severe SDB (RDI ≥ 30) in each group was as follows: 20% in the TIA group, 32% in the stroke group [71% in the large artery atherosclerosis group, 36% in the cardioembolism group, 25% in the small vessel occlusion group, 24% in the other/undetermined cause of stroke group], and 41% in the intracerebral hemorrhage group. The patients with more than 3 vascular risk factors were more frequently in the severe SDB group than in other groups (p=0.0052). SBD was frequently complicated in the cerebrovascular disease patients. In conclusion, Japanese patients with acute cerebrovascular disease should be assessed for SDB regardless of obesity and severe stroke.
