Dysarthria plus dysphagia is associated with severe sleep-disordered breathing in patients with acute intracerebral hemorrhage

• Published in: European journal of neurology Vol. 21; no. 2; pp. 344 - 348
• Main Authors: Shibazaki, K., Kimura, K., Aoki, J., Uemura, J., Fujii, S., Sakai, K.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.02.2014; John Wiley & Sons, Inc
• Subjects: Age; Aged; Aged, 80 and over; Body Mass Index; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - physiopathology; Confidence intervals; Deglutition Disorders - complications; Deglutition Disorders - physiopathology; dysarthria; Dysarthria - complications; Dysarthria - physiopathology; Dysphagia; Female; Humans; intracerebral hemorrhage; Male; Middle Aged; Polysomnography; Prospective Studies; Regression analysis; Risk Factors; Sleep Apnea Syndromes - complications; Sleep Apnea Syndromes - physiopathology; sleep-disordered breathing; Waist Circumference; intracerebral hemorrhage; dysphagia; sleep-disordered breathing; dysarthria
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/ene.12323

Background and purpose Sleep‐disordered breathing (SDB) is a risk factor for stroke. The frequency of SDB in Japanese patients with acute intracerebral hemorrhage (ICH) was investigated, as well as factors associated with SDB severity. Methods Between April 2010 and April 2013, patients with ICH within 24 h of onset were prospectively enrolled to participate in a sleep study within 7 days of admission. SDB was defined as a respiratory disturbance index (RDI: apnea or hypopnea events per hour) of ≥5. Patients were assigned to groups based on RDI values of ≥30 (severe SDB) and <30 (absent or not severe SDB). The frequency of SDB and factors associated with its severity were investigated using multivariate logistic regression analysis. Results Of 97 patients (55 males; mean age 68.1 years) enrolled in the study, 91 (94%) had SDB. Severe SDB was evident in 29 (30%) patients. Compared with the RDI< 30 group, the RDI≥ 30 group had a higher frequency of dysarthria plus dysphagia (76% vs. 47%, P = 0.008), larger waist circumference [86 (84–92) vs. 84 (78–88) cm, P = 0.019] and a greater body mass index [23.8 (21.1–26.8) vs. 21.5 (19.4–25.0) kg/m2, P = 0.046]. Multivariate logistic regression analysis showed that dysarthria plus dysphagia was independently associated with severe SDB (odds ratio 3.4; 95% confidence interval 1.250–9.252, P = 0.017). Conclusion Most Japanese patients with acute ICH had SDB, and dysarthria plus dysphagia was associated with severe SDB.