Pre-screening of sleep-disordered breathing after stroke : A systematic review

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Takala , M , Puustinen , J , Rauhala , E & Holm , A 2018 , ' Pre-screening of sleep-disordered breathing after stroke : A systematic review ' , Brain and Behavior , vol. 8 , no. 12 , 01146 . https://doi.org/10.1002/brb3.1146

Title: Pre-screening of sleep-disordered breathing after stroke : A systematic review
Author: Takala, Mari; Puustinen, Juha; Rauhala, Esa; Holm, Anu
Contributor: University of Helsinki, Divisions of Faculty of Pharmacy
Date: 2018-12
Language: eng
Number of pages: 12
Belongs to series: Brain and Behavior
ISSN: 2162-3279
URI: http://hdl.handle.net/10138/299401
Abstract: Objectives Sleep-Disordered Breathing (SDB) is frequent in stroke patients. Polysomnography (PSG) and cardiorespiratory polygraphy are used to confirm SDB, but the need for PSG exceeds the available resources for systematic testing. Therefore, a simple and robust pre-screening instrument is necessary to identify the patients with an urgent need for a targeted PSG. The aim of this systematic review was to identify and evaluate the available methods to pre-screen stroke patients possibly suffering from SDB. Materials and Methods Eleven studies out of 3,561 studies met the inclusion criteria. The selected studies assessed the efficiency of seven instruments based on the data acquired clinically or by inquiries (Berlin Questionnaire, Epworth Sleepiness Scale, SOS, Modified Sleep Apnea Scale of the Sleep Disorders Questionnaire, STOP-BANG, Four-variable Screening Tool and Multivariate Apnea Index) and three physiological measures (capnography, nocturia, nocturnal oximetry). The instruments were used to predict SDB in patients after acute or subacute stroke. Either PSG or cardiorespiratory polygraphy was used as a standard to measure SDB. Results No independent studies using the same questionnaires, methods or criteria were published reducing generalizability. Overall, the questionnaires were quite sensitive in finding SDB but not highly specific in identifying the non-affected. The physiological measures (capnography) indicated promising results in predicting SDB, but capnography is not an ideal pre-screening instrument as it requires a specialist to interpret the results. Conclusions The results of pre-screening of SDB in acute and subacute stroke patients are promising but inconsistent. The current pre-screening methods cannot readily be referred to clinicians in neurologic departments. Thus, it is necessary to conduct more research on developing novel pre-screening methods for detecting SDB after stroke.
Subject: pre-screening
sleep-disordered sleeping
stroke
systematic review
RISK-FACTOR
APNEA
QUESTIONNAIRE
TOOL
3124 Neurology and psychiatry
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