Intracerebral Hemorrhage and Sleep-Disordered Breathing

Publication date: Available online 29 March 2018
Source:Sleep Medicine
Author(s): Lynda D. Lisabeth, Richard V. Scheer, Chengwei Li, Erin Case, Ronald D. Chervin, Darin B. Zahuranec, Lewis B. Morgenstern, Nelda M. Garcia, Susan Tower, Devin L. Brown
Objective/BackgroundLimited data are available on sleep-disordered breathing (SDB) following intracerebral hemorrhage (ICH). Our aim was to characterize objective measures of post-ICH SDB, and questionnaire-reported pre-ICH sleep characteristics, overall and by ethnicity.Patients/MethodsParticipants with ICH 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 sub-sample was screened for SDB (respiratory event index ≥10) using ApneaLink Plus portable monitoring. Ethnic differences in post-ICH SDB or reported pre-ICH sleep were assessed using log binomial or linear regression models or a Fisher's Exact test.ResultsICH 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 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 high risk for pre-ICH SDB, and median pre-ICH sleep duration was 8 hours (IQR: 6, 8). No ethnic differences emerged in high risk for SDB or sleep duration pre-ICH, after adjustment for confounders.ConclusionsNearly half of 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.



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