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Baillieul S, Dekkers M, Brill AK, et al. Sleep apnoea and ischaemic stroke: current knowledge and future directions. Lancet Neurol. 2022;21(1):78-88doi: 10.1016/S1474-4422(21)00321-5.
Baillieul, S., Dekkers, M., Brill, A. K., Schmidt, M. H., Detante, O., Pépin, J. L., Tamisier, R., & Bassetti, C. L. A. (2022). Sleep apnoea and ischaemic stroke: current knowledge and future directions. The Lancet. Neurology, 21(1), 78-88. https://doi.org/10.1016/S1474-4422(21)00321-5
Baillieul, Sébastien, et al. "Sleep apnoea and ischaemic stroke: current knowledge and future directions." The Lancet. Neurology vol. 21,1 (2022): 78-88. doi: https://doi.org/10.1016/S1474-4422(21)00321-5
Baillieul S, Dekkers M, Brill AK, Schmidt MH, Detante O, Pépin JL, Tamisier R, Bassetti CLA. Sleep apnoea and ischaemic stroke: current knowledge and future directions. Lancet Neurol. 2022 Jan;21(1):78-88. doi: 10.1016/S1474-4422(21)00321-5. PMID: 34942140.
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Lancet Neurol. 2022 Jan;21(1):78-88. doi: 10.1016/S1474-4422(21)00321-5.

Sleep apnoea and ischaemic stroke: current knowledge and future directions.

The Lancet. Neurology

Sébastien Baillieul, Martijn Dekkers, Anne-Kathrin Brill, Markus H Schmidt, Olivier Detante, Jean-Louis Pépin, Renaud Tamisier, Claudio L A Bassetti

Affiliations

  1. Department of Neurology, Inselspital, University Hospital, Bern, Switzerland; Service Universitaire de Pneumologie Physiologie, Grenoble Alpes University Hospital, Grenoble, France; Inserm U1300, Grenoble Institute of Neurosciences, Université Grenoble Alpes, Grenoble, France.
  2. Department of Neurology, Inselspital, University Hospital, Bern, Switzerland.
  3. Department of Pulmonary Medicine, Inselspital, University Hospital, Bern, Switzerland.
  4. Department of Neurology, Inselspital, University Hospital, Bern, Switzerland; Ohio Sleep Medicine Institute, Dublin, OH, USA.
  5. Stroke Unit, Neurology Department, Grenoble Alpes University Hospital, Grenoble, France; Inserm U1216, Grenoble Institute of Neurosciences, Université Grenoble Alpes, Grenoble, France.
  6. Service Universitaire de Pneumologie Physiologie, Grenoble Alpes University Hospital, Grenoble, France; Inserm U1300, Grenoble Institute of Neurosciences, Université Grenoble Alpes, Grenoble, France.
  7. Department of Neurology, Inselspital, University Hospital, Bern, Switzerland. Electronic address: [email protected].

PMID: 34942140 DOI: 10.1016/S1474-4422(21)00321-5

Abstract

Sleep apnoea, one of the most common chronic diseases, is a risk factor for ischaemic stroke, stroke recurrence, and poor functional recovery after stroke. More than half of stroke survivors present with sleep apnoea during the acute phase after stroke, with obstructive sleep apnoea being the most common subtype. Following a stroke, sleep apnoea frequency and severity might decrease over time, but moderate to severe sleep apnoea is nevertheless present in up to a third of patients in the chronic phase after an ischaemic stroke. Over the past few decades evidence suggests that treatment for sleep apnoea is feasible during the acute phase of stroke and might favourably affect recovery and long-term outcomes. Nevertheless, sleep apnoea still remains underdiagnosed and untreated in many cases, due to challenges in the detection and prediction of post-stroke sleep apnoea, uncertainty as to the optimal timing for its diagnosis, and a scarcity of clear treatment guidelines (ie, uncertainty on when to treat and the optimal treatment strategy). Moreover, the pathophysiology of sleep apnoea associated with stroke, the proportion of stroke survivors with obstructive and central sleep apnoea, and the temporal evolution of sleep apnoea subtypes following stroke remain to be clarified. To address these shortcomings, the management of sleep apnoea associated with stroke should be integrated into a multidisciplinary diagnostic, treatment, and follow-up strategy.

Copyright © 2022 Elsevier Ltd. All rights reserved.

Conflict of interest statement

Declaration of interests SB has received travel grants from AGIRàDom, outside the submitted work. MHS has received grants from Interfaculty Research Cooperation and Innosuisse (30664.1IP-LS), paid dir

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