BENEFITS OF EARLY DIAGNOSIS AND TREATMENT OF OBSTRUCTIVE SLEEP APNEA-HYPOPNEA SYNDROME IN PATIENTS WITH ACUTE ISCHEMIC STROKE:
SASS (Sleep Apnea in Stroke patients Study)

Domínguez-Mayoral A¹, Sánchez-Miura J¹, Pérez-Sánchez S¹, De Torres R¹, Ferrer M², Guerrero P², Benítez JM², Sánchez J², Gamero MA¹, Barragán A¹, Ferrete E¹, Montaner J¹  
¹Neurology Department. Virgen Macarena Hospital. Sevilla. Spain. 
²Neumology Department. Virgen Macarena Hospital. Sevilla. Spain.

BACKGROUND 
Obstructive sleep apnea-hypopnea syndrome (OSAHS) may influence the prognosis of acute ischemic stroke (AIS). Our objective is to study the impact of early screening and treatment of OSAHS in AIS at the stroke unit.
METHODS
24 patients with AIS <72 hours were included. The sample was divided in two groups (n=12 in each arm). The protocol in the active group (A) included a cardiorespiratory polygraphy and CPAP if OSAHS was detected. In the control group (C) patients received standard clinical care. Epidemiological and clinical data was collected in both groups.  
RESULTS
Both groups were homogeneous in sex, age, prevalence of vascular risk factors, baseline NIHSS and percentage of large-vessel occlusions, thrombolysis and thrombectomy. In the group A, OSAHS prevalence was 100% and more than half were moderate or severe obstructive cases (medium apnea-hypopnea index 21.12). Mean saturation and CT90% was 11.2 and 92.6% respectively. The sensitivity of Berlin questionnaire was 66%. Mortality was 16.6% in C (pneumonia and myocardial infarction) and 0% in A. Mean three-month mRS and Barthel were 1.10 and 90.83 in A vs 2.58 and 80.50 in C (p=0.33). Quality of life parameters were better in A than in C according to SF-36 test (the percentage of patients that reported good health was twice in A). 
CONCLUSIONS
Acute polygraphy is feasible in patients with AIS. Early treatment of OSAHS could improve stroke outcome, although larger multicentric studies are necessary to confirm these results.

BENEFITS OF EARLY DIAGNOSIS AND TREATMENT OF OBSTRUCTIVE SLEEP APNEA-HYPOPNEA SYNDROME IN PATIENTS WITH ACUTE ISCHEMIC STROKE: SASS (SLEEP APNEA IN STROKE PATIENTS STUDY)