The Association of Lesion Location and Sleep Related Breathing Disorder in Patients with Acute Ischemic Stroke

PLoS One. 2017 Jan 30;12(1):e0171243. doi: 10.1371/journal.pone.0171243. eCollection 2017.


Background and aims: Sleep related breathing disorders (SRBD) are common in patients with ischemic stroke and are associated with poor outcome. SRBD after stroke were assumed to be a direct consequence of injury of specific central nervous system structures. However, whether specific locations of ischemic infarcts cause SRBD is yet unknown. We therefore investigated the association of ischemic lesion location with SRBD.

Methods: Patients with acute ischemic stroke treated on our stroke unit were included in a prospective observational study. All patients underwent magnetic resonance imaging (MRI) and polygraphy in the acute phase after stroke. SRBD was defined by an apnea-hypopnea index (AHI) ≥10. MRI were evaluated using standardized maps to depict voxel-wise probability distribution of infarction for patients with and without SRBD. Groups were compared using logistic regression analysis.

Results: Of 142 patients included, 86 (59%) had a SRBD. Age, body mass index and prevalence of arterial hypertension were significantly higher in patients with SRBD. There was no statistically significant association between any lesion location and SRBD.

Conclusion: We found no association of lesion location and SRBD in stroke patients, whereas established risk factors for SRBD, known from general population, were significantly associated with SRBD. Given the high prevalence of SRBD in stroke patients, these findings suggest that cerebral ischemia facilitates the occurrence of SRBD in patients with pre-existing risk factors rather than causing it by damaging specific central nervous system structures. Our findings can be used to identify stroke patients who might benefit from polygraphy screening.

MeSH terms

  • Aged
  • Brain Ischemia / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sleep Apnea Syndromes / complications*
  • Stroke / complications*

Grant support

JM is supported by the Else Kröner-Fresenius-Stiftung (2014_EKES.16). HW is supported by a grant from the German Federal Ministry of Education and Research (BMBF, grant 01ER0816). PY is supported by the Löwensteinstiftung and the German Federal Ministry of Education and Research (BMBF, grant 01GM1511E). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.