Cerebral Hemodynamic Changes in Stroke During Sleep-Disordered Breathing

Background and Purpose-Sleep-disordered breathing (SDB) negatively impacts stroke outcome. Near-infrared spectroscopy showed the acute cerebral hemodynamic effects of SDB. Methods-Eleven patients (7 men, age 61 +/- 13 years) with acute/subacute middle cerebral artery stroke (National Institutes of Health Stroke Scale score 10 +/- 7) and SDB (apnea-hypopnea index 32 +/- 28/hour) were assessed with nocturnal polysomnography and bilateral near-infrared spectroscopy recording. Cerebral oxygenation and hemoglobin concentration changes during obstructive and central apneas were analyzed. Results-During SDB, near-infrared spectroscopy showed asymmetrical patterns of cerebral oxygenation and hemoglobin concentrations with changes significantly larger on the unaffected compared with the affected hemisphere. Brain tissue hypoxia was more severe during obstructive compared with central apneas. Conclusions-Profound cerebral deoxygenation effects of SDB occurred in acute/subacute stroke. These changes may contribute to poor outcome, arising in the possibility of a potential benefit of SDB treatment in stroke management. (Stroke. 2012;43:1951-1953.)