Obstructive sleep apnoea (OSA) is said to be associated with stroke and can be modulated to advantage. Given its impact on atrial fibrillation (AF), a predictor of severity and poor stroke outcome, we decided to study the relationship of OSA with arrhythmias and outcome in stroke patients admitted on our service. Stroke patients admitted and confirmed by neuro-imaging were examined physically, underwent 24 hour Holter monitoring and assessed for severity, dependency and survival status by 4 weeks after admission. They had arterial blood saturation checked between 10 pm and 2 am. Saturation < 90% defined OSAS and it was correlated with presence of arrhythmias, severity of stroke and outcome measures. Ninety four patients (52 M, 42 F) were enrolled. Ten, 6 M 4 F had OSA with a mean age of 56.00±16.80 years. AF was more associated with OSA to a statistically significant extent (chi-square=7.453, p=0.006). When it comes to mortality or whether patient was still on admission or had been discharged by 4 weeks, presence of OSA made an obvious difference. (chi-square=16.202. p=0.001). Those with OSA were more dependent 4 weeks after admission and had more severe stroke, but the difference missed statistical significance. In conclusion, OSA in stroke patients is fraught with a high risk of arrhythmias in which presence strokes are more severe with poorer outcomes. Appropriate management of OSA in patients at risk of stroke or after the ictus is bound to mitigate the burden and consequences of stroke.
| Published in | American Journal of Internal Medicine (Volume 9, Issue 3) |
| DOI | 10.11648/j.ajim.20210903.15 |
| Page(s) | 138-141 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Obstructive Sleep Apnea, Arrhythmias, Stroke, Severity, Outcome
| [1] | Maeder MT, Schoch OD, Rickli H. A clinical approach to obstructive sleep apnoea as a risk factor for cardiovascular disease. Vasc. Health. Risk Mgt. 2016; 12: 85–103. |
| [2] | Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014; 383 (9918): 736–747. |
| [3] | Xie W, Zheng F, Song X. Obstructive sleep apnoea and serious adverse outcomes in patients with cardiovascular and cerebrovascular disease. A PRISMA-compliant systematic review and meta-analysis. Medicine. 2014; 93 (29): 1–8. |
| [4] | Bonsignore MR, Baiamonte P, Mazzuca E, Castrogiovanni A, Marrone O. Obstructive sleep apnoea and co-morbidities: a dangerous liaison. Multidisciplinary Resp Med. 2019. 14 (6). Httpps://doi.org/10.1186/s40248-019-0172-9. |
| [5] | Ciccone MM, Schicchitano P, Mitacchione G, Zito A, Gesualdo M, Caputo P et al. Is there a correlation between OSAS duration/severity and carotid intima media thickness. Respir Med. 2012; 106 (5): 740–746. Doi: 10.1016/jrmed.20011.12.016. |
| [6] | Kozub E. Community stroke prevention programme. An overview. J. NeuroScience Nursing. 2010; 42 (3): 143–149. |
| [7] | Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N et al. Heart disease and Stroke statistics; 2008 update: A report from the American Heart Association Statistics Committee and Stroke Statistics sub-committee. Circulation. 2008; 117 (4): e25–e146. |
| [8] | Birabi B, Oke K, Dienye P, Okafor UC. Cost burden of post stroke condition in Nigeria: a pilot study. Glob J. Health Sci. 2012; 4 (6): 17–22. |
| [9] | Osuntokun B, Adeuja A, Schoenberg B, Bademosi O, Nottidge VA, Olumide AO et al. Neurological disorders in Nigerian Africans: a community based study. Acta Neurol Scand. 1987; 75 (1): 13–21. |
| [10] | Danesi M, Okubadejo N, Ojini F. Prevalence of stroke in an urban mixed-income community in Lagos Nigeria. Neuroepid. 2007 28 (4): 216–223. |
| [11] | Hahne K, Monnig G, Samol A. Atrial fibrillation and silent strokes: links, risks and challenges, Vasc Health Risk Mgt. 2016; 12: 65–74. |
| [12] | Kandzerska T, Gershon AS, Hawker G, Leung RS, Tomlinson G. Obstructive sleep apnoea and risk of cardiovascular events and all-cause mortality. A decade long historical cohort study. PLOS Medicine. 2014; 11 (2): e 1001599. Doi: 10.1371/journal.pmed.1001599. |
| [13] | Zhao Y, Zou C, Wang C, Zhang Y, Wang S. Long term outcome after stroke in elderly patients with atrial fibrillation. A hospital based study in China. Front. Aging Neurosci. 2016; 8: 56. |
| [14] | Gutierrez C, Blanchard DG. Atrial fibrillation: Diagnosis and treatment. Am. Fam. Physician. 2011; 83 (1): 61-68. |
| [15] | Bertolami A, Gonzaga C, Amodeo C. Cardiac function and hypertension in patients with obstructive sleep apnoea. Res. Rep. Clin Cardiol. 2014; 45: 189–197. |
| [16] | Geovanini GR, Lorenzi-Filho G,. Cardaiac rhythm disorders in obstructive sleep apnoea. J. Thoac. Dis. 2018. (Suppl 34): S4221–4230. |
| [17] | Monahan K, Stofer-Issar A, Mehra R, Shahar E, Mittlemann M, Rottman J et al. Triggering of nocturnal arrhythmias by sleep disordered breathing events. J Am Coll Cardiol. 2009; 54 (19): 1797–1804. |
| [18] | Kanagala R, Murali NS, Friedman PA, Ammash NM, Gersh BJ, Baalman KV et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation. 2003. 107 (20): 2589-2594. |
| [19] | Mooe T, Franklin KA, Wiklund U, Rabben T, Holmström K. Cardiac rhythm in patients with sleep-disordered breathing and coronary artery disease. Scand Cardiovasc J. 2000.34 (3): 272-276. |
| [20] | Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnoea. Nat. Rev. Cardiol. 2010; 7: 677–685. |
| [21] | Somers VK, Javaheri S. Cardiovascular effects of sleep related breathing disorders. In: Roth T, Demet WC (eds). Principles and practice of sleep Medicine. 5th edi. St Louis MO. USA. Elsevier Sanders. 2011: 1370–1380. |
| [22] | Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD et al. Resistant hypertension diagnosis evaluation and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation. 2008; 117 (25): e510–e526. |
| [23] | O’Brien E, Parchi G, Steigon G, Asman R, Beilin L, Bilo G et al. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens. 2013; 31: 1731–1768. |
| [24] | Lloyd EE, Durgan DJ, Martini SR, Bryan RM. Pathological effects of obstructive sleep apneas during the sleep cycle in an animal model of cerebral small vessel disease. Hypertens. 2015; 66: 913–917. DOI: 10.1161/HYPERTENSIONAHA.115.05764. |
| [25] | Tawfik A, Bielechi JM, Krahn M, Dorian P, Hoch JS, Boon H et al. Systematic review and network meta-analysis of stroke prevention treatments in patients with atrial fibrillation. Clin Pharm Advances and Applications. 2016; 8: 93–107. |
| [26] | Gami AS, Howard DE, Olsen EJ, Somers VR. Day-night pattern of sudden death in obstructive sleep apnoea. New Eng J Med. 2005; 352 (12): 1206–1214. |
| [27] | Gami AS, Hodge DO, Herges RM, Olsom DJ, Nykodim J, Kara T et al. Obstructive sleep apnoea obesity and the risk of incident atrial fibrillation. J. Am Coll. Cardiol. 2007; 49 (5): 565–571. |
| [28] | Mehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchna HL et al. Association of nocturnal arrhythmias with sleep discordant breathing. The Sleep Heart Health Study. Am J Respir Crit Care Med. 2006; 173 (8): 910-916. |
| [29] | Jehen S, Farag M, Zizi F, Pandi-Perumai SR, Chung A, Truong a et al. Obstructive sleep apnoea and stroke. Sleep Med Disord. 2018; 2 (5): 120–125. |
APA Style
Basil Nwaneri Okeahialam, Patrick Oyigebe Idoko. (2021). Impact of Obstructive Sleep Apnoea on Rate of Dysrrhythmia and Outcome in Stroke Admissions on the Medical Service of Jos University Teaching Hospital. American Journal of Internal Medicine, 9(3), 138-141. https://doi.org/10.11648/j.ajim.20210903.15
ACS Style
Basil Nwaneri Okeahialam; Patrick Oyigebe Idoko. Impact of Obstructive Sleep Apnoea on Rate of Dysrrhythmia and Outcome in Stroke Admissions on the Medical Service of Jos University Teaching Hospital. Am. J. Intern. Med. 2021, 9(3), 138-141. doi: 10.11648/j.ajim.20210903.15
AMA Style
Basil Nwaneri Okeahialam, Patrick Oyigebe Idoko. Impact of Obstructive Sleep Apnoea on Rate of Dysrrhythmia and Outcome in Stroke Admissions on the Medical Service of Jos University Teaching Hospital. Am J Intern Med. 2021;9(3):138-141. doi: 10.11648/j.ajim.20210903.15
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Download@article{10.11648/j.ajim.20210903.15,
author = {Basil Nwaneri Okeahialam and Patrick Oyigebe Idoko},
title = {Impact of Obstructive Sleep Apnoea on Rate of Dysrrhythmia and Outcome in Stroke Admissions on the Medical Service of Jos University Teaching Hospital},
journal = {American Journal of Internal Medicine},
volume = {9},
number = {3},
pages = {138-141},
doi = {10.11648/j.ajim.20210903.15},
url = {https://doi.org/10.11648/j.ajim.20210903.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210903.15},
abstract = {Obstructive sleep apnoea (OSA) is said to be associated with stroke and can be modulated to advantage. Given its impact on atrial fibrillation (AF), a predictor of severity and poor stroke outcome, we decided to study the relationship of OSA with arrhythmias and outcome in stroke patients admitted on our service. Stroke patients admitted and confirmed by neuro-imaging were examined physically, underwent 24 hour Holter monitoring and assessed for severity, dependency and survival status by 4 weeks after admission. They had arterial blood saturation checked between 10 pm and 2 am. Saturation < 90% defined OSAS and it was correlated with presence of arrhythmias, severity of stroke and outcome measures. Ninety four patients (52 M, 42 F) were enrolled. Ten, 6 M 4 F had OSA with a mean age of 56.00±16.80 years. AF was more associated with OSA to a statistically significant extent (chi-square=7.453, p=0.006). When it comes to mortality or whether patient was still on admission or had been discharged by 4 weeks, presence of OSA made an obvious difference. (chi-square=16.202. p=0.001). Those with OSA were more dependent 4 weeks after admission and had more severe stroke, but the difference missed statistical significance. In conclusion, OSA in stroke patients is fraught with a high risk of arrhythmias in which presence strokes are more severe with poorer outcomes. Appropriate management of OSA in patients at risk of stroke or after the ictus is bound to mitigate the burden and consequences of stroke.},
year = {2021}
}
TY - JOUR T1 - Impact of Obstructive Sleep Apnoea on Rate of Dysrrhythmia and Outcome in Stroke Admissions on the Medical Service of Jos University Teaching Hospital AU - Basil Nwaneri Okeahialam AU - Patrick Oyigebe Idoko Y1 - 2021/05/31 PY - 2021 N1 - https://doi.org/10.11648/j.ajim.20210903.15 DO - 10.11648/j.ajim.20210903.15 T2 - American Journal of Internal Medicine JF - American Journal of Internal Medicine JO - American Journal of Internal Medicine SP - 138 EP - 141 PB - Science Publishing Group SN - 2330-4324 UR - https://doi.org/10.11648/j.ajim.20210903.15 AB - Obstructive sleep apnoea (OSA) is said to be associated with stroke and can be modulated to advantage. Given its impact on atrial fibrillation (AF), a predictor of severity and poor stroke outcome, we decided to study the relationship of OSA with arrhythmias and outcome in stroke patients admitted on our service. Stroke patients admitted and confirmed by neuro-imaging were examined physically, underwent 24 hour Holter monitoring and assessed for severity, dependency and survival status by 4 weeks after admission. They had arterial blood saturation checked between 10 pm and 2 am. Saturation < 90% defined OSAS and it was correlated with presence of arrhythmias, severity of stroke and outcome measures. Ninety four patients (52 M, 42 F) were enrolled. Ten, 6 M 4 F had OSA with a mean age of 56.00±16.80 years. AF was more associated with OSA to a statistically significant extent (chi-square=7.453, p=0.006). When it comes to mortality or whether patient was still on admission or had been discharged by 4 weeks, presence of OSA made an obvious difference. (chi-square=16.202. p=0.001). Those with OSA were more dependent 4 weeks after admission and had more severe stroke, but the difference missed statistical significance. In conclusion, OSA in stroke patients is fraught with a high risk of arrhythmias in which presence strokes are more severe with poorer outcomes. Appropriate management of OSA in patients at risk of stroke or after the ictus is bound to mitigate the burden and consequences of stroke. VL - 9 IS - 3 ER -
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