An Overnight Rhythmic Sleep-Wake Pattern in Stroke and Obstructive Sleep Apnea: A Case Report and Literature Review

Hamed  Amirifard; Arezu  Najafi; Ania  Rahimi-Golkhandan; Mahsa   Shojaie

doi:10.18502/jss.v5i1.4571

Hamed Amirifard
Arezu Najafi
Ania Rahimi-Golkhandan
Mahsa Shojaie

DOI: https://doi.org/10.18502/jss.v5i1.4571

Keywords: Obstructive sleep apnea; Stroke; Continuous positive airway pressure; Arousal

Abstract

Background and Objective: Obstructive sleep apnea (OSA) is a common sleep breathing disorder and a comorbid condition in patients with stroke. The prevalence of sleep disorders as a stroke consequence is high. Being independent of vascular risk factors, OSA is associated with increased risk of ischemic stroke. Here, we report a patient with OSA and stroke.

Case Report: This case report presents a patient with a history of stroke and hemiparesis who underwent polysomnog-raphy (PSG) for evaluating OSA because of snoring, witnessed apnea, and excessive daytime sleepiness (EDS). Then the subject underwent continuous positive airway pressure (CPAP) titration for treating OSA. In first night of PSG, there was a repetitive cyclic pattern of sleep and arousals. After CPAP titration study and with CPAP pressure of 15 cmH2o, OSA and rhythmic changes of electroencephalography (EEG) were resolved.

Conclusion: OSA as a risk factor for stroke can be associated with PSG cyclic wake-sleep pattern in these patients, and this pattern can be resolved by CPAP therapy.