EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke [guidelines].

Bassetti, Claudio L.A.; Randerath, Winfried; Vignatelli, Luca; Ferini-Strambi, Luigi; Brill, Anne-Kathrin; Bonsignore, Maria R; Grote, Ludger; Jennum, Poul; Leys, Didier; Minnerup, Jens; Nobili, Lino; Tonia, Thomy; Morgan, Rebecca; Kerry, Joel; Riha, Renata; McNicholas, Walter T; Papavasileiou, Vasileios (2020). EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke [guidelines]. European respiratory journal, 55(4), p. 1901104. European Respiratory Society 10.1183/13993003.01104-2019

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Sleep disorders are highly prevalent in the general population and may be linked in a bidirectional fashion to stroke, which is one of the leading causes of morbidity and mortality.Four major scientific societies established a task force of experts in neurology, stroke, respiratory medicine, sleep medicine and methodology, to critically evaluate the evidence regarding potential links and the impact of therapy. 13 research questions were evaluated in a systematic literature search using a stepwise hierarchical approach: first, systematic reviews and meta-analyses; second, primary studies post-dating the systematic reviews/meta-analyses. A total of 445 studies were evaluated and 88 included. Statements were generated regarding current evidence and clinical practice.Severe obstructive sleep apnoea (OSA) doubles the risk for incident stroke, especially in young to middle-aged patients. Continuous positive airway pressure (CPAP) may reduce stroke risk, especially in treatment-compliant patients. The prevalence of OSA is high in stroke patients and can be assessed by polygraphy. Severe OSA is a risk factor for recurrence of stroke and may be associated with stroke mortality, while CPAP may improve stroke outcome. It is not clear if insomnia increases stroke risk, while pharmacotherapy of insomnia may increase it. Periodic limb movements in sleep (PLMS), but not restless limb syndrome (RLS), may be associated with an increased risk of stroke. Preliminary data suggest a high frequency of post-stroke insomnia and RLS and their association with a less favourable stroke outcome, while treatment data are scarce.Overall, the evidence base is best for OSA relationship with stroke and supports active diagnosis and therapy. Research gaps remain especially regarding insomnia and RLS/PLMS relationships with stroke.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Bassetti, Claudio; Brill, Anne-Kathrin and Tonia, Thomai

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0903-1936

Publisher:

European Respiratory Society

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

07 May 2020 12:10

Last Modified:

26 Jun 2020 02:27

Publisher DOI:

10.1183/13993003.01104-2019

PubMed ID:

32317355

Additional Information:

The article has been co‐published with permission in the European Respiratory Journal and the European Journal of Neurology. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.

BORIS DOI:

10.7892/boris.143761

URI:

https://boris.unibe.ch/id/eprint/143761

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