Mythirayee S, Baskar Dipti, Seethalakshmi G, Yadav Ravi, Kamble Nitish L, Kulkarni Girish Baburao, Sinha Sanjib, Mailankody Pooja, Srijithesh P R
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Ann Indian Acad Neurol. 2025 Mar 1;28(2):241-246. doi: 10.4103/aian.aian_730_24. Epub 2025 Apr 10.
Sleep-disordered breathing is highly prevalent in stroke patients. It is associated with recurrence of stroke and poor neurologic outcomes. Polysomnography (PSG), the gold standard for diagnosing sleep apnea, may not be feasible for routine evaluation in stroke patients. There is a need for reliable screening tools to assess the likelihood of sleep apnea in these patients. This study evaluated the efficacy of sleep questionnaires to predict the likelihood of sleep apnea against PSG-determined sleep apnea.
A hospital-based study on ischemic stroke patients used the content-validated Kannada version of Berlin Questionnaire, STOP-BANG questionnaire, and Epworth Sleepiness Scale (ESS). All patients underwent overnight PSG, scored by blinded investigators, to assess the diagnostic properties of the questionnaires for various apnea-hypopnea index cutoffs.
The study included 70 Kannada-speaking patients with a mean age of 50.9 years. The study revealed a high prevalence of sleep apnea (80%), with obstructive sleep apnea being the most common type (77.5%). The Berlin Questionnaire showed modest sensitivity (0.51) and specificity (0.60), while the STOP-BANG questionnaire demonstrated moderate sensitivity (0.64) and specificity (0.70). The mean ESS scores were 6.6 (standard deviation [SD] 5.9) for patients with sleep apnea and 4.3 (SD 3.1) for those without sleep apnea.
Sleep questionnaires lacked the necessary diagnostic properties to serve as standalone screening tools for sleep apnea in ischemic stroke patients. Future research should aim to develop or improve screening instruments specifically designed for stroke patients.
睡眠呼吸障碍在中风患者中非常普遍。它与中风复发和不良神经学预后相关。多导睡眠图（PSG）是诊断睡眠呼吸暂停的金标准，但对于中风患者的常规评估可能不可行。需要可靠的筛查工具来评估这些患者发生睡眠呼吸暂停的可能性。本研究评估了睡眠问卷针对PSG确定的睡眠呼吸暂停来预测睡眠呼吸暂停可能性的有效性。
一项基于医院的对缺血性中风患者的研究使用了经内容验证的卡纳达语版柏林问卷、STOP-BANG问卷和爱泼华嗜睡量表（ESS）。所有患者均接受了由盲法研究者评分的夜间PSG检查，以评估问卷对于不同呼吸暂停低通气指数截断值的诊断特性。
该研究纳入了70名讲卡纳达语的患者，平均年龄为50.9岁。研究显示睡眠呼吸暂停的患病率很高（80%），其中阻塞性睡眠呼吸暂停是最常见的类型（77.5%）。柏林问卷显示出中等的敏感性（0.51）和特异性（0.60），而STOP-BANG问卷表现出中等的敏感性（0.64）和特异性（0.70）。有睡眠呼吸暂停的患者的ESS平均评分为6.6（标准差[SD]5.9），无睡眠呼吸暂停的患者为4.3（SD 3.1）。
睡眠问卷缺乏作为缺血性中风患者睡眠呼吸暂停独立筛查工具所需的诊断特性。未来的研究应旨在开发或改进专门为中风患者设计的筛查工具。
