Nocturnal blood pressure regulation in stroke patients with sleep apnea

• Published in: Sleep medicine 2013-12, Vol.14, p.e255-e255
• Main Authors: Saletu, M, Kotzian, S, Schiefer, I, Hillberger, M, Spatt, J
• Format: Article
• Language: English
• Subjects: Neurology; Sleep Medicine
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2013.11.618

Introduction In clinical routine, stroke patients with sleep apnea (SA) show a different blood pressure (BP) response to respiratory events. The aim of the study was to evaluate the impact of age, comorbidity, medication, etiology and location of cerebral lesions on nocturnal (BP) in stroke patients with SA. Materials and methods Respirographic sleep studies were performed in all stroke patients that underwent neurorehabilitation. Their systolic BP was determined by means of a non-linear algorithm and an individual one-point calibration of the pulse transit time obtained with a cuff-based BP measuring (SOMNOmedics GmbH, Germany). The number of systolic rises (defined as >15 mmHg) was scored. Risk factor evaluation, Oxfordshire Community Stroke Project (OCSP) and TOAST classification were performed. Results Out of the 203 stroke patients (age 58 ± 12;) enrolled in the study, 38% were suffering from SA (AHI > 15). They showed a median of 47 ± 38 BP rises per hour, with a median rise by 19 ± 3 mmHg,and a median nocturnal systolic BP of 138 ± 26 mmHg. In 7 patients, no apnea-related BP rises were observed (non-responders). Etiologically, they showed an equal distribution of small-artery occlusion (3), large-artery atherosclerosis (1), stroke of other determined cause (1), or undetermined cause (1), cardioembolism (1) and cerebral hemorrhage (1). There were neither differences in OCSP vessel lesions nor influence factors for the non- responders. Conclusion 9.1% of stroke patients with SA show an atypical blood pressure response to apneas (non-responders). The missing blood pressure response doesn’t seem to be correlated with age, comorbidity, clinical symptoms, medication, etiology, or cerebral lesion.