Sleep apnea screening is uncommon after stroke.
Female
Health Status Disparities
Humans
Male
Mexican Americans
/ statistics & numerical data
Polysomnography
/ statistics & numerical data
Practice Patterns, Physicians'
/ statistics & numerical data
Risk Factors
Self Report
Sleep Apnea, Obstructive
/ diagnosis
Stroke
/ ethnology
Texas
/ epidemiology
White People
/ statistics & numerical data
Cerebrovascular disease/stroke
Sleep apnea
Journal
Sleep medicine
ISSN: 1878-5506
Titre abrégé: Sleep Med
Pays: Netherlands
ID NLM: 100898759
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
23
07
2018
revised:
05
09
2018
accepted:
19
09
2018
pubmed:
30
11
2018
medline:
4
8
2020
entrez:
29
11
2018
Statut:
ppublish
Résumé
To assess (1) pre and post-stroke screening for sleep apnea (SA) within a population-based study without an academic medical center, and (2) ethnic differences in post-stroke sleep apnea screening among Mexican Americans (MAs) and non-Hispanic whites (NHWs). MAs and NHWs with stroke in the Brain Attack Surveillance in Corpus Christi project (2011-2015) were interviewed shortly after stroke about the pre-stroke period, and again at approximately 90 days after stroke in reference to the post-stroke period. Questions included whether any clinical provider directly asked about snoring or daytime sleepiness or had offered polysomnography. Logistic regression tested the association between these outcomes and ethnicity both unadjusted and adjusted for potential confounders. Among 981 participants, 63% were MA. MAs in comparison to NHWs were younger, had a higher prevalence of hypertension, diabetes, and never smoking, a higher body mass index, and a lower prevalence of atrial fibrillation. Only 17% reported having been offered SA diagnostic testing pre-stroke, without a difference by ethnicity. In the post-stroke period, only 50 (5%) participants reported being directly queried about snoring; 86 (9%) reported being directly queried about sleepiness; and 55 (6%) reported having been offered polysomnography. No ethnic differences were found for these three outcomes, in unadjusted or adjusted analyses. Screening for classic symptoms of SA, and formal testing for SA, are rare within the first 90 days after stroke, for both MAs and NHWs. Provider education is needed to raise awareness that SA affects most patients after stroke and is associated with poor outcomes.
Sections du résumé
OBJECTIVE/BACKGROUND
To assess (1) pre and post-stroke screening for sleep apnea (SA) within a population-based study without an academic medical center, and (2) ethnic differences in post-stroke sleep apnea screening among Mexican Americans (MAs) and non-Hispanic whites (NHWs).
PATIENTS/METHODS
MAs and NHWs with stroke in the Brain Attack Surveillance in Corpus Christi project (2011-2015) were interviewed shortly after stroke about the pre-stroke period, and again at approximately 90 days after stroke in reference to the post-stroke period. Questions included whether any clinical provider directly asked about snoring or daytime sleepiness or had offered polysomnography. Logistic regression tested the association between these outcomes and ethnicity both unadjusted and adjusted for potential confounders.
RESULTS
Among 981 participants, 63% were MA. MAs in comparison to NHWs were younger, had a higher prevalence of hypertension, diabetes, and never smoking, a higher body mass index, and a lower prevalence of atrial fibrillation. Only 17% reported having been offered SA diagnostic testing pre-stroke, without a difference by ethnicity. In the post-stroke period, only 50 (5%) participants reported being directly queried about snoring; 86 (9%) reported being directly queried about sleepiness; and 55 (6%) reported having been offered polysomnography. No ethnic differences were found for these three outcomes, in unadjusted or adjusted analyses.
CONCLUSIONS
Screening for classic symptoms of SA, and formal testing for SA, are rare within the first 90 days after stroke, for both MAs and NHWs. Provider education is needed to raise awareness that SA affects most patients after stroke and is associated with poor outcomes.
Identifiants
pubmed: 30482619
pii: S1389-9457(18)30454-4
doi: 10.1016/j.sleep.2018.09.009
pmc: PMC6437010
mid: NIHMS1508171
pii:
doi:
Types de publication
Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
90-93Subventions
Organisme : NINDS NIH HHS
ID : R01 NS070941
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL126700
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS038916
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL098065
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS091112
Pays : United States
Organisme : NINDS NIH HHS
ID : U10 NS086526
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL123379
Pays : United States
Organisme : NINDS NIH HHS
ID : U24 NS107214
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS069498
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2018 Elsevier B.V. All rights reserved.
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