Sleep-related breathing disorders:: impact on mortality of cerebrovascular disease

The aim of the study was to analyse the impact of sleep-related breathing disorders in a 2-yr survival follow-up of patients with a first ever stroke or transient ischaemic attack. The study followed 161 patients. Complete neurological assessment was performed in order to determine cerebrovascular risk factors, functional disability, and parenchy-matous and vascular localisation, as well as stroke subtype categorisation. A sleep study was carried out using a portable respiratory recording device. The entire cohort was followed over a mean period of 22.8 months. The main outcome event was death and time of survival since the neurological event. A multivariate Cox's model was estimated. The patients were ages 72+/-9 yrs (mean+/-SD), and had a body mass index of 26.6+/-3.9 kg.m(-2) and apnoea/hypopnoea index (AHI) of 21.2+/-15.7. Overall, mortality occurred in 22 cases, and the survival rate was 86.3%. Vascular disease accounted for 63.6% of deaths. Multivariate analysis selected four independent variables associated with mortality: 1) age; 2) AHI, with an implied 5% increase in mortality risk for each additional unit of A H 1; 3) involvement of the middle cerebral artery; and 4) the presence of coronary disease. In conclusion, the findings suggest that sleep-related breathing disorders are an independent prognostic factor related to mortality after a first episode of stroke.