Research About Sleep Position Of Obstrustive Sleep Apnea-Hypopnea Syndrome In The Patients With Acute Cerebral Infarction

Objective To explore the role of sleep position in the patients with obstrustive sleepapnea-hypopnea syndrome and acute cerebral infarction.Methods Consecutive patients were enrolled, who have been determined by brainMRI and polysomnography (PSG) with acute cerebral infarction and OSAHS. Theywere stratified in a group of positional patients(PP)(AHI supine≥2×AHI otherpositions) and a group of non-positional patients(NPP)(AHI supine＜2×AHI otherpositions). Postural characteristics of sleep-disordered breathing, stroke riskfactors, clinical features and characteristics of brain magnetic resonance imagingwere compared between the two groups. Postural characteristics of sleep-disorderedbreathing, stroke risk factors were compared between OSAHS patients accompaniedwith and without acute cerebral infarction.Results In122patients with ischemic stroke,67.2%（82/122）was found to havesleep breathing disordered. Among them,87.8%（72/82）had OSAHS,3.7%（3/82）had CSA,8.5%（7/82） had MSA. OSAHS patients accompanied with ischemicstroke had higher prevalence of Hypertension, Diabetes, Hyperlipidemia and smokethan those without (P<0.05). Among72OSAHS patients accompanied with ischemicstroke,58.3%（42/72）were positional ones, whose supine AHI were30.70±11.20,whose supine sleep time percents was55.6%. Those with non-positional OSAHS hadsupine AHI19.66±8.9and supine sleep time percents45.2%(P<0.05). The formerhad higher prevalence of Hypertension, Hyperlipidemia and Heart disease than thelatter. Comparaing the first cerebral infarction group with recurrent ones showed thatthe latter had more severe sleep breathing disordered, regardless of the PPgroup or NPP group. The prevalence of positional patients in anterior circulationgroup，in posterior circulation group and in all the circulation group was75%，51%and3.6%，respectively. The prevalence of positional patients in anterior circulationgroup was significantly different from posterior circulation group. The prevalence ofpositional patients in lacunar infarction group was higher than in non-lacunarinfarction group（P=0.047）. Lacunar infarction patients had more supine sleep （P=0.001）. Prevalence of positional patients in the NIHSS score≥7group was84.6%（11/13）, AHI, supine AHI and supine sleep time percent of which was32.12，35.43and72.3%, respectively. prevalence of positional patients in the NIHSSscore<7group was52.5%（31/59），AHI, supine AHI and supine sleep time percentof which was26.04，29.34and63.5%, respectively.Conclusion Acute cerebral infarction patients accompanied with OSAHS had ahigher prevalence of positional patients, especially infarction location of which wasbigger, NIHSS score was higher and the infarction was recurrent.