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. 2021 Oct;49(10):3000605211053090.
doi: 10.1177/03000605211053090.

High prevalence of obstructive sleep apnea syndrome in Spain's Stroke Belt

Ana Domínguez-Mayoral  1   2 , Jesús Sánchez-Gómez  3 , Patricia Guerrero  3 , Marta Ferrer  3 , Carmen Gutiérrez  4 , María Aguilar  4 , Natalia Fouz-Rosón  3 , José María Benítez  3 , Soledad Pérez-Sánchez  1   2 , Miguel Ángel Gamero-García  1   2 , Reyes De Torres-Chacón  1   2 , Ana Barragán-Prieto  1   2 , Pilar Algaba  2 , Lidia Ruiz-Bayo  1 , Joan Montaner  1   2
Affiliations

High prevalence of obstructive sleep apnea syndrome in Spain's Stroke Belt

Ana Domínguez-Mayoral et al. J Int Med Res. 2021 Oct.

Abstract

Objective: Spain's so-called Stroke Belt is an area with high prevalence of vascular disease. We aimed to determine the prevalence of undetected obstructive sleep apnea-hypopnea syndrome (OSAHS) among patients with acute ischemic stroke (AIS) in southern Spain.

Methods: We conducted a cross-sectional study at the Virgen Macarena University Hospital Stroke Unit during 2018 to 2019. We included patients <72 hours after AIS with a neuroimaging lesion and performed sleep tests.

Results: Seventy-two patients were included. The median participant age was 72 years. Mean body mass index was 27.07 kg/m2, and 40.28% were daily alcohol drinkers. Hypertension, atrial fibrillation, ischemic cardiomyopathy, and previous stroke were detected in 63.9%, 11.1%, 15.3%, and 17.6% of patients, respectively. Polygraphy was feasible in 91.38% of patients. The prevalence of OSAHS was 84.72% (apnea-hypopnea index ≥5). Patients with moderate and severe OSAHS were more likely to be obese and to have a larger neck circumference and facial palsy. The diagnostic criteria of central sleep apnea syndrome were met in only 1.38% of patients.

Conclusions: The high prevalence of OSAHS found in the Spanish Stroke Belt justifies further investigation and development of a screening program as a strategy to identify patients with undetected OSAHS.

Keywords: Spanish Stroke Belt; ischemic stroke; obstructive sleep apnea–hypopnea syndrome; polygraphy; polysomnography; screening.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Study design. Sample size, reasons for screening failure, and type of sleep test performed.
Figure 2.
Figure 2.
Prevalence of obstructive sleep apnea–hypopnea syndrome (OSAHS) according to apnea–hypopnea index (AHI) cutoff point.
See this image and copyright information in PMC

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