Post-stroke sleep-disordered breathing - pathophysiology and therapy options
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Date
2018-02-26
Authors
Stevens, David
Martins, Rodrigo Tomazini
Mukherjee, Sutapa
Vakulin, Andrew
Journal Title
Journal ISSN
Volume Title
Publisher
Frontiers Media
Rights
Copyright © 2018 Stevens, Martins, Mukherjee and Vakulin. This is an open-access
article distributed under the terms of the Creative Commons Attribution License
(CC BY). The use, distribution or reproduction in other forums is permitted, provided
the original author(s) and the copyright owner are credited and that the original
publication in this journal is cited, in accordance with accepted academic practice.
No use, distribution or reproduction is permitted which does not comply with
these terms.
Rights Holder
Copyright © 2018 Stevens, Martins, Mukherjee and Vakulin.
Abstract
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep
apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast
improvements in post-stroke functional recovery outcomes after the treatment of SDB
by continuous positive airway pressure. However, compliance to this therapy is very poor
in this complex patient group. There are alternative therapy options for SDB that may
be more amenable for use in at least some post-stroke patients, including mandibular
advancement, supine avoidance, and oxygen therapy. There are few studies, however,
that demonstrate efficacy and compliance with these alternative therapies currently.
Furthermore, novel SDB-phenotyping approaches may help to provide important
clinical information to direct therapy selection in individual patients. Prior to realizing
individualized therapy, we need a better understanding of the pathophysiology of SDB
in post-stroke patients, including the role of inherent phenotypic traits, as well as the
contribution of stroke size and location. This review summarizes the available literature
on SDB pathophysiology and treatment in post-stroke patients, identifies gaps in the
literature, and sets out areas for further research.
Description
Note: This article was submitted to
Otorhinolaryngology - Head and
Neck Surgery,
a section of the journal
Frontiers in Surgery. This is an open-access
article distributed under the terms of the Creative Commons Attribution License
(CC BY). The use, distribution or reproduction in other forums is permitted, provided
the original author(s) and the copyright owner are credited and that the original
publication in this journal is cited, in accordance with accepted academic practice.
No use, distribution or reproduction is permitted which does not comply with
these terms.
Keywords
stroke, sleep apnea, hypopnea, treatment, phenotyping
Citation
Stevens, D., Martins, R.T., Mukherjee, S. and Vakulin, A., (2018). Post-Stroke Sleep-Disordered Breathing — Pathophysiology and Therapy Options. Front. Surg. 5:9. doi: 10.3389/fsurg.2018.00009.