Role of Obstructive Sleep Apnea in Stroke Appearance
Condition: Stroke; Obstructive Sleep Apnea
MeSH terms: Apnea; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Stroke
Study type: Observational

Summary: 
      Stroke is the third leading cause of death in industrialized countries and the first cause of
      handicap in adults. Several stroke risk factors were identified such as high blood pressure,
      diabetes mellitus, hypercholesterolemia or cardiac arrhythmias. Sleep respiratory disorders
      have been found to be frequent among patients with stroke. Among them obstructive sleep apnea
      (OSA) syndrome seems to be the most important due to its association with high blood pressure
      and atrial fibrillation.

      Stroke can be responsible of central apneas, therefore the differential diagnosis between
      central apneas and pure OSA after stroke is sometimes difficult. The misidentification of OSA
      can explain the poor tolerance of CPAP treatment by these patients. The purpose of the
      present study is to investigate the association between pre-stroke OSA syndrome OSA diagnosed
      on specific scales and confirmed by polygraphic studies and stroke occurrence.
    

Detailed description: 
      • Principal Objective : Investigate the association between obstructive sleep apnea diagnosed
      and hemispheric ischemic stroke

      • Secondary Objective :

      Evaluate the relation between obstructive sleep apnea and:

        -  stroke mechanisms

        -  stroke prognosis

        -  post-stroke tolerance to CPAP treatment.

             -  Study design :

      Prospective case-control study

      • Inclusion criteria :

      Patients (150):

      Fist ischaemic hemispheric stroke or TIA Age: 50 to 90 French native speaker Able to answer
      the questions

      Controls (600):

      Age: 50 to 90 French native speaker Able to answer the questions

      • Exclusion criteria : Patients Haemorrhagic stroke Stroke of the brainstem Past medical
      history of ischaemic stroke Dementia Confusion Unable to give his informed consent

      Controls:

      Past medical history of ischaemic stroke Dementia Confusion Unable to give his informed
      consent

      • Study plan: Cases will be recruited in the stroke unit of the Pr Orgogozo at the Bordeaux
      University hospital. After verification of inclusion and exclusion criteria Berlin scale will
      be measured. A polygraphic study will be performed to patients with a Berlin scale > 2.
      Patients stroke characteristics will be recorded (initial severity, stroke mechanism) at
      baseline and stroke outcome will be evaluated at 3 months (stroke recurrence and functional
      outcome).

      Controls will be recruited among sex and age matched patients hospitalized at the
      Bordeaux-University hospital for investigation of non-vascular disorder. After verification
      of inclusion and exclusion criteria Berlin scale will be measured. A polygraphic study will
      be performed to subjects with a Berlin scale > 2. Controls will be evaluated at 3 months
      using a phone interview

      • Number of subjects : 150 cases and 600 controls
    

Intervention name(s): polygraphic study
Intervention type(s): Other
Intervention description(s): Berlin scale will be measured. A polygraphic study will be performed to subjects with a Berlin scale > 2.
Patients stroke characteristics will be recorded (initial severity, stroke mechanism) at baseline and stroke outcome will be evaluated at 3 months (stroke recurrence and functional outcome).
Controls will be evaluated at 3 months using a phone interview
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Cases will be recruited in the stroke unit at the Bordeaux University hospital Controls
        will be recruited among sex and age matched patients hospitalized at the
        Bordeaux-University hospital for investigation of non-vascular disorder
      
Keywords: Sleep apnea, Berlin, Stroke