Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun:46:114-116.
doi: 10.1016/j.sleep.2018.03.005. Epub 2018 Mar 29.

Intracerebral hemorrhage and sleep-disordered breathing

Lynda D Lisabeth  1 , Richard V Scheer  2 , Chengwei Li  3 , Erin Case  3 , Ronald D Chervin  4 , Darin B Zahuranec  2 , Lewis B Morgenstern  5 , Nelda M Garcia  2 , Susan Tower  6 , Devin L Brown  2
Affiliations

Intracerebral hemorrhage and sleep-disordered breathing

Lynda D Lisabeth et al. Sleep Med. 2018 Jun.

Abstract

Objective/background: Limited data are available on sleep-disordered breathing (SDB) following intracerebral hemorrhage (ICH). Our aim was to characterize the objective measures of post-ICH SDB and questionnaire-reported pre-ICH sleep characteristics, overall and by ethnicity.

Patients/methods: Participants with ICH who were enrolled in the population-based Brain Attack Surveillance in Corpus Christi project (2010-2016) reported their pre-ICH sleep duration and completed the Berlin Questionnaire to characterize pre-ICH risk of SDB. A subsample was screened for SDB (respiratory event index ≥10) using ApneaLink Plus portable monitoring. Ethnic differences in post-ICH SDB or questionnaire-reported pre-ICH sleep characteristics were assessed using a log binomial model or a linear regression model or a Fisher's exact test.

Results: ICH cases (n = 298) were enrolled (median age = 68 years, 67% Mexican American). Among 62 cases with complete ApneaLink data, median time to post-ICH SDB screening was 11 days (IQR: 6, 19). Post-ICH SDB prevalence was 46.8% (95% CI: 34.4-59.2), and this rate did not differ by ethnicity (p = 1.0). Berlin Questionnaires for 109 of the 298 ICH cases (36.6% (95% CI: 31.1-42.0)) suggested a high risk for pre-ICH SDB, and the median pre-ICH sleep duration was eight hours (IQR: 6, 8). After adjusting for confounders, there was no difference in ethnicity in high risk for pre-ICH SDB or pre-ICH sleep duration.

Conclusions: Nearly half of the patients had objective confirmation of SDB after ICH, and more than one-third had questionnaire evidence of high risk for pre-ICH SDB. Opportunities to address SDB may be common both before and after ICH.

Keywords: Intracerebral hemorrhage; Sleep; Sleep apnea; Sleep disorders.

PubMed Disclaimer

References

    1. Johnson KG, Johnson DC. Frequency of sleep apnea in stroke and TIA patients: A meta-analysis. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. 2010;6:131–137. - PMC - PubMed
    1. Shibazaki K, Kimura K, Aoki J, Uemura J, Fujii S, Sakai K. Dysarthria plus dysphagia is associated with severe sleep-disordered breathing in patients with acute intracerebral hemorrhage. European journal of neurology. 2014;21:344–348. - PubMed
    1. Hemphill JC, 3rd, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: A guideline for healthcare professionals from the American heart association/American stroke association. Stroke. 2015;46:2032–2060. - PubMed
    1. Lisabeth LD, Sanchez BN, Chervin RD, Morgenstern LB, Zahuranec DB, Tower SD, et al. High prevalence of poststroke sleep-disordered breathing in Mexican Americans. Sleep Med. 2017;33:97–102. - PMC - PubMed
    1. Piriyawat P, Šmajsová M, Smith M, Pallegar S, Al-Wabil A, Garcia N, et al. Comparison of active and passive surveillance for cerebrovascular disease: The Brain Attack Surveillance in Corpus Christi (BASIC) project. American journal of epidemiology. 2002;156:1062–1069. - PubMed

Publication types