Huhtakangas JK, et al. - The prevalence, type, and severity of sleep apnea during the acute phase of ischemic stroke was compared among patients either receiving or not receiving thrombolysis. In the vast majority of ischemic stroke patients, sleep apnea was present. The stroke patients treated with thrombolysis were more prone to have sleep apnea, to have elevated National Institutes of Health Stroke Scale (NIHSS) score at admission, and to be younger. Among those receiving thrombolysis, sleep apnea was more severe as compared to those who were not.

• A total of 246 consecutive adult ischemic stroke patients were enrolled.
• During the first 48 hours after the symptom onset of ischemic stroke, patients underwent cardiorespiratory sleep study with portable 3-channel device.

• In this study, the authors recruited 110 (65.5% male) stroke patients in the thrombolysis group and 94 (59.6% male) in the nonthrombolysis group.
• The median National Institutes of Health Stroke Scale (NIHSS) score was higher (5.5) in the thrombolysis group compared to the nonthrombolysis group (2.0) (p < 0.001).
• In the thrombolysis group, there was a lower incidence of lacunar (17.3% vs 36.2%, p = 0.002) and cerebellar (2.7% vs 16.0%, p < 0.001) strokes and a higher frequency of middle cerebral artery syndrome (60.9% vs 33.0%, p < 0.001) than the nonthrombolysis group.
• In 186 (91.2%) patients, sleep apnea defined as an apnea-hypopnea index (AHI) ≥ 5/h was diagnosed, its prevalence being higher in the thrombolysis (96.4%) compared to the nonthrombolysis (85.1%) group (p = 0.007).
• In the thrombolysis group, the mean baseline AHI was 33.7/h compared to 26.8/h in the nonthrombolysis group (p = 0.017).