Sleep-Disordered Breathing in Patients Enrolled in an Inpatient Stroke Rehabilitation Program

OBJECTIVE: To report the prevalence of sleep-disordered breathing in an inpatient stroke rehabilitation unit and to explore correlations with functional status and health-related quality of life. DESIGN: Cross-sectional study. SETTING: Rehabilitation center. PARTICIPANTS: Consecutive patients (N=45; mean age, 67+/-12y) (28 men) enrolled in inpatient rehabilitation after ischemic (84%) or hemorrhagic stroke (16%). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Overnight respiratory polysomnography was performed on all subjects. Interviewer-administered scales of sleepiness (Epworth Sleepiness Scale) and functional status (FIM, Barthel Index) were completed. Health-related quality of life was assessed by using a general questionnaire (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]). RESULTS: Of the 45 subjects tested, only 4 (9%) had an apnea-hypopnea index of less than 10 per hour. The mean apnea-hypopnea index was 32.2 (19.4) per hour; most events were obstructive. There was no relationship between the respiratory index and the components of SF-36 (P values>.2). CONCLUSIONS: There was a dramatically high prevalence of respiratory events in patients after stroke enrolled in an inpatient stroke rehabilitation unit. The awareness of this will influence patient evaluation and management.