The Relationship Between Obstructive Sleep Apnea and Ruptured Intracranial Aneurysms.

Abstract

STUDY OBJECTIVES:

The role of obstructive sleep apnea (OSA) in the overall outcome of ruptured intracranial aneurysms (RIAs) is unknown. We have investigated the role of OSA in overall outcome of RIAs.

METHODS:

Data from 159 consecutive patients were retrospectively reviewed. A chi-square test and regression analysis were performed to determine the significant difference. A value of P < .05 was considered significant.

RESULTS:

The prevalence of OSA in RIAs was fivefold higher in the nonaneurysm patient group, P = .002. The number of patients with hypertension (P < .0001), body mass index ≥ 30 (P < .0001), hyperlipidemia (P = .018), chronic heart disease (P = .002) or prior ischemic stroke (P = .001) was significantly higher in the OSA group. Similarly, the number of wide-neck aneurysms (P < .0001) and aneurysm > 7 mm (P = .004), poor Hunt and Hess grade IV-V (P = .005), vasospasms, (P = .03), and patients with poor Modified Rankin Scale scores (3-6) was significantly higher in the OSA group (P < .0001). Interestingly, for the first time in univariate (P = .01) and multivariate (P = .003) regression analysis, OSA was identified as an individual predictor of unfavorable outcome of RIAs. In addition, hypertension (P = .04), smoking (P = .049), chronic heart disease (P = .01), and Hunt and Hess grade IV-V (P = .04) were revealed as predictors of poor outcome of RIAs.

CONCLUSIONS:

This is a novel study to determine the association between OSA and ruptured cerebral aneurysm in terms of comorbidities, size of aneurysm, severity of symptoms, and outcomes after treatment. In addition, for the first time, OSA is identified as a positive predictor of unfavorable outcome of RIAs.

• Authors: Oleg Y Chernyshev, Shyamal C Bir, Tanmoy K Maiti, Devi Prasad Patra, Hai Sun, Bharat Guthikonda, Roger E Kelley, Hugo Cuellar, Alireza Minagar, Anil Nanda
• Journal: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (J Clin Sleep Med) Vol. 15 Issue 12 Pg. 1839-1848 (12 15 2019) ISSN: 1550-9397 [Electronic] United States
• PMID: 31839111 (Publication Type: Journal Article)
• Copyright: © 2019 American Academy of Sleep Medicine.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aneurysm, Ruptured (complications, surgery)
• Continuous Positive Airway Pressure (methods)
• Endovascular Procedures (methods)
• Female
• Humans
• Intracranial Aneurysm (complications, surgery)
• Male
• Middle Aged
• Retrospective Studies
• Severity of Illness Index
• Sleep Apnea, Obstructive (complications, therapy)
• Treatment Outcome
• Young Adult