| Title: |
Obstructive and central sleep apnea in first ever ischemic stroke are associated with different time course and autonomic activation |
| Authors: |
Riglietti A.; Fanfulla F.; Pagani M.; Lucini D.; Malacarne M.; Manconi M.; Ferretti G.; Esposito F.; Cereda C. W.; Pons M. |
| Contributors: |
Riglietti A.; Fanfulla F.; Pagani M.; Lucini D.; Malacarne M.; Manconi M.; Ferretti G.; Esposito F.; Cereda C. W.; Pons M. |
| Publication Year: |
2021 |
| Collection: |
Università degli Studi di Brescia: OPENBS - Open Archive UniBS |
| Subject Terms: |
Baroreflex; Brain lesion; Chemoreflex; Sleep-disordered breathing |
| Description: |
Introduction: Sleep-related breathing disorders are highly prevalent in patients with ischemic stroke. Among sleep-disordered breathing disorders, obstructive sleep apnea is the most represented one, but central sleep apnea, isolated or in the context of a periodic breathing/Cheyne–Stokes respiration, is frequently reported in these patients. Altered baror-eflex responses have been reported in the acute phases of a cerebral event. Methods: We conducted, in a group of patients with ischemic stroke (n=60), a prospective 3-month follow-up physiological study to describe the breathing pattern during sleep and baroreflex sensitivity in the acute phase and in the recovery phase. Results: In the acute phase, within 10 days from the onset of symptoms, 22.4% of patients had a normal breathing pattern, 40.3% had an obstructive pattern, 16.4% had a central pattern, and 29.9% showed a mixed pattern. Smaller variations in the Apnea–Hypopnea Index were found in normal breathing and obstructive groups (ΔAHI 2.1±4.1 and −2.8±11.6, respectively) in comparison with central and mixed patterns (ΔAHI −6.9±15.1 and −12.5 ±13.1, respectively; ANOVA p=0.01). The obstructive pattern became the most frequent pattern, in 38.3% of patients at baseline and 61.7% of patients at follow-up. Modification of baroreflex sensitivity over time was influenced by the site of the lesion and by the sleep disorder pattern in the acute phase (MANOVA p=0.005). Conclusion: We suggest that a down-regulation of autonomic activity, possibly related to reduced vagal modulation, may help the recovery after stroke, or a transitory disconnection from the cortical node that participates in the regulation of sympathetic outflow. |
| Document Type: |
article in journal/newspaper |
| File Description: |
STAMPA |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/34295200; info:eu-repo/semantics/altIdentifier/wos/WOS:000674422100003; volume:13; firstpage:1167; lastpage:1178; numberofpages:12; journal:NATURE AND SCIENCE OF SLEEP; http://hdl.handle.net/11379/554835 |
| DOI: |
10.2147/NSS.S305850 |
| Availability: |
http://hdl.handle.net/11379/554835; https://doi.org/10.2147/NSS.S305850 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.22DB7F41 |
| Database: |
BASE |