Article

Sleep apnea syndrome (SAS) frequently occurs after a stroke. Its
association with a poor prognosis is open to discussion. OBJECTIVE: To study, in
a physical and rehabilitation medicine (PRM) unit, the possible repercussions of
SAS on neurological and functional recovery as well as attentional abilities
following a stroke.
METHOD : Forty-five patients, all of whom had
recently had a stroke without previously documented SAS, were screened using the
ApneaLink((R)) system. An apnea-hypopnea index (AHI) score >/=10 was considered
as indicative of SAS. The NIHSS, Fugl-Meyer (FM) and Functional Independence
Measure (FIM) Scales were applied on admission and at two months as means of
assessing neurological and functional recovery, which was expressed by the
difference between the first and the second scores (delta FM, delta NIHSS, delta
FIM). The Battery Attention William Lennox (BAWL) Test was given once in order to
evaluate attention disorders. SAS severity was categorized according to the AHI.
We compared the groups formed (mild, moderate and severe) using the same method.
RESULTS: Twenty-eight patients (62.2%) presented AHI >/= 10. Stroke
characteristics were comparable in the SAS+ and the SAS- groups, with average
post-stroke time lapse of 26 days, initial average FIM score of 71.2 points +/-
26.3 and initial average NIHSS score of 8.9 +/- 4.9. The demographic
characteristics of the two groups were likewise comparable with the exception of
age, as the SAS+ group was pronouncedly older (65.4 vs. 53.5 years). As for delta
FIM, which evaluated functional recovery, it averaged 31.8 +/- 20.6. Cases of SAS
were found to be mild (37.1%), moderate (28.6%) or severe (34.3%). No significant
difference was observed on admission or at 2 months as regards the clinical
scales or the BAWL test between the two groups or according to severity, except
for the NIHSS score at 2 months in the severe sub-group.
CONCLUSION: This study did not demonstrate the supposed repercussions of SAS on
the recovery or attentional abilities of post-stroke patients. The tests were
maybe given too early; they should take place at a lengthier time interval after
the stroke, and also to be more complete.
CI - Copyright (c) 2014 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS ; FRANCAIS