Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea Index
Background and Objective Sleep apnea affects two-thirds of acute ischemic stroke (AIS) patients, but its prognostic utility remains debated. This study evaluates nocturnal hypoxemia metrics and traditional sleep apneic indices as predictors of post-stroke functional outcomes. Methods This prospectiv...
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Korean Society of Sleep Medicine
2025-06-01
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| Series: | Sleep Medicine Research |
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| Online Access: | http://sleepmedres.org/upload/pdf/smr-2025-02845.pdf |
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| author | Tho Dinh Phung Giap Van Vu Dung Viet Nguyen Hoai Thi Thu Nguyen |
| author_facet | Tho Dinh Phung Giap Van Vu Dung Viet Nguyen Hoai Thi Thu Nguyen |
| author_sort | Tho Dinh Phung |
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| description | Background and Objective Sleep apnea affects two-thirds of acute ischemic stroke (AIS) patients, but its prognostic utility remains debated. This study evaluates nocturnal hypoxemia metrics and traditional sleep apneic indices as predictors of post-stroke functional outcomes. Methods This prospective cohort study enrolled patients with AIS at the Stroke Center of Bach Mai Hospital between April and October 2024. Participants underwent overnight cardiorespiratory polygraphy. Functional outcomes (modified Rankin Scale [mRS]) were evaluated at 3 months. Multivariate logistic regression analysis identified predictors of unfavorable outcomes (mRS >1). Results Of the 125 AIS patients enrolled (median National Institutes of Health Stroke Scale [NIHSS] score 3, interquartile range 2–4), 66.4% were diagnosed with sleep apnea (apnea-hypopnea index [AHI] >10). At 3-month follow-up, univariate analysis revealed that younger age, absence of diabetes, lower baseline NIHSS, absence of early neurological deterioration (END), lower AHI, reduced oxygen desaturation index (ODI), higher mean SpO2, and shorter percentage of time with SpO2 <90% were significantly associated with favorable functional outcomes (all p<0.05). In multivariate logistic regression, NIHSS, END, diabetes, ODI, percentage of time with SpO2 <90%, and mean SpO2 were independent predictors of unfavorable outcomes (all p<0.05). Notably, AHI did not show a significant association with outcomes (p>0.05). Conclusions NIHSS, END, diabetes, and nocturnal hypoxemia—not AHI—independently predict post-stroke disability. Hypoxemia duration (ODI, % time SpO2 <90%) offers superior prognostic value, advocating for sleep apnea management strategies targeting hypoxia mitigation. |
| format | Article |
| id | doaj-art-6bb054e6f8994515aad2f6fe180bdf41 |
| institution | DOAJ |
| issn | 2093-9175 2233-8853 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Korean Society of Sleep Medicine |
| record_format | Article |
| series | Sleep Medicine Research |
| spelling | doaj-art-6bb054e6f8994515aad2f6fe180bdf412025-08-20T02:47:35ZengKorean Society of Sleep MedicineSleep Medicine Research2093-91752233-88532025-06-0116210911410.17241/smr.2025.02845322Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea IndexTho Dinh Phung0Giap Van Vu1Dung Viet Nguyen2Hoai Thi Thu Nguyen3 Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam Respiratory Center, Bach Mai Hospital, Hanoi, Vietnam Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, VietnamBackground and Objective Sleep apnea affects two-thirds of acute ischemic stroke (AIS) patients, but its prognostic utility remains debated. This study evaluates nocturnal hypoxemia metrics and traditional sleep apneic indices as predictors of post-stroke functional outcomes. Methods This prospective cohort study enrolled patients with AIS at the Stroke Center of Bach Mai Hospital between April and October 2024. Participants underwent overnight cardiorespiratory polygraphy. Functional outcomes (modified Rankin Scale [mRS]) were evaluated at 3 months. Multivariate logistic regression analysis identified predictors of unfavorable outcomes (mRS >1). Results Of the 125 AIS patients enrolled (median National Institutes of Health Stroke Scale [NIHSS] score 3, interquartile range 2–4), 66.4% were diagnosed with sleep apnea (apnea-hypopnea index [AHI] >10). At 3-month follow-up, univariate analysis revealed that younger age, absence of diabetes, lower baseline NIHSS, absence of early neurological deterioration (END), lower AHI, reduced oxygen desaturation index (ODI), higher mean SpO2, and shorter percentage of time with SpO2 <90% were significantly associated with favorable functional outcomes (all p<0.05). In multivariate logistic regression, NIHSS, END, diabetes, ODI, percentage of time with SpO2 <90%, and mean SpO2 were independent predictors of unfavorable outcomes (all p<0.05). Notably, AHI did not show a significant association with outcomes (p>0.05). Conclusions NIHSS, END, diabetes, and nocturnal hypoxemia—not AHI—independently predict post-stroke disability. Hypoxemia duration (ODI, % time SpO2 <90%) offers superior prognostic value, advocating for sleep apnea management strategies targeting hypoxia mitigation.http://sleepmedres.org/upload/pdf/smr-2025-02845.pdfischemic strokeneurologic manifestationssleep apneahypoxemia |
| spellingShingle | Tho Dinh Phung Giap Van Vu Dung Viet Nguyen Hoai Thi Thu Nguyen Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea Index Sleep Medicine Research ischemic stroke neurologic manifestations sleep apnea hypoxemia |
| title | Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea Index |
| title_full | Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea Index |
| title_fullStr | Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea Index |
| title_full_unstemmed | Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea Index |
| title_short | Sleep Apnea-Related Hypoxemia Predicts Post-Stroke Disability Better Than Apnea-Hypopnea Index |
| title_sort | sleep apnea related hypoxemia predicts post stroke disability better than apnea hypopnea index |
| topic | ischemic stroke neurologic manifestations sleep apnea hypoxemia |
| url | http://sleepmedres.org/upload/pdf/smr-2025-02845.pdf |
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