J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website http://www.neurores.org

Original Article

Volume 1, Number 4, October 2011, pages 145-152

Early Sleep Apnea Detection and Treatment in Stroke Rehabilitation

Figure 1. Fugl-Meyer Upper Extremity comparison at baseline and at 30 days between both groups: Obstructive Sleep Apneas treated with BiPAP versus Obstructive Sleep Apneas without BiPAP treatment. Abbreviations: Obstructive Sleep Apnea with BiPAP Treatment (OSA with BiPAP); Obstructive Sleep Apnea without BiPAP Treatment (OSA without BiPAP).

Figure 2. Fugl-Meyer Lower Extremity comparison at baseline and at 30 days between both groups: Obstructive Sleep Apneas treated with BiPAP versus Obstructive Sleep Apneas without BiPAP treatment. Abbreviations: Obstructive Sleep Apnea with BiPAP Treatment (OSA with BiPAP); Obstructive Sleep Apnea without BiPAP Treatment (OSA without BiPAP).

**Table 1.** Comparison at Baseline of Treatment and Control Group
	Obstructive Sleep Apneas
Patients (n)	13	12
Age yrs (Mean)	60	65.5
Range	55 - 68	58 - 72
Sex
Male	8	6
Female	5	6
Hypertension	10 (76.9%)	10 (83.3%)
Hypercholesterolemia	5 (38.4%)	2 (16.6%)
Smoking	4 (30.7%)	4 (33.3%)
Diabetes Mellitus	1 (7.7%)	4 (33.3%)
Coronary heart disease	5 (38.4%)	1 (8.33%)
Cardiac arrhythmias	3 (23%)	1 (8.33%)
Ischemic stroke location
Supratentorial, n (%)	12 (92.3%)	11 (91.7%)
Infratentorial, n (%)	1 (7.7%)	1 (8.3%)
NIH score
Mean	10	10
Range	5 - 14	5 - 16
Body Mass Index
Mean	28.33	27.68
Range	18 - 41	20 - 37

Table 1. Comparison at Baseline of Treatment and Control Group

Obstructive Sleep Apneas

With BiPAP

Without BiPAP

Patients (n)

Age yrs (Mean)

65.5

Range

55 - 68

58 - 72

Sex

Male

Female

Hypertension

10 (76.9%)

10 (83.3%)

Hypercholesterolemia

5 (38.4%)

2 (16.6%)

Smoking

4 (30.7%)

4 (33.3%)

Diabetes Mellitus

1 (7.7%)

4 (33.3%)

Coronary heart disease

5 (38.4%)

1 (8.33%)

Cardiac arrhythmias

3 (23%)

1 (8.33%)

Ischemic stroke location

Supratentorial, n (%)

12 (92.3%)

11 (91.7%)

Infratentorial, n (%)

1 (7.7%)

1 (8.3%)

NIH score

Mean

Range

5 - 14

5 - 16

Body Mass Index

Mean

28.33

27.68

Range

18 - 41

20 - 37

**Table 2.** Comparison at Baseline and 30 Days
	Baseline	Day 30	Absolute change (Day 30-Baseline)	p-Value
Comparison at Baseline and 30 Days in the OSA With BiPAP Group and in the OSA Without BiPAP Treatment (Intragroup Comparison) in the Following Scales: Functional Independence Measure, Barthel Index, Fugl-Meyer Motor Assessment Upper and Lower Extremities, Addenbroke’s Cognitive, Examination, Frontal Assessment Battery, Digit Span Subtest of the Wechsler Memory Test. Data are presented as median (percentiles 25-75) unless otherwise stated; * Statistical Significance.
FIM
OSA w/Bipap	43 (24.5 - 50.5)	61 (57 - 91.5)	18	0.001*
OSA	44 (23 - 49)	70 (38.5 - 75.7)	26	0.002*
BI
OSA w/Bipap	5 (0 - 25)	50 (12.5 - 57.5)	45	0.001*
OSA	7.5 (0 - 15)	27.5 (5 - 43.7)	20	0.003*
FMUE
OSA w/Bipap	5 (4 - 31)	24 (4 - 47)	19	0.018*
OSA	4 (4 - 4)	4 (4 - 6.75)	0	0.041*
FMLE
OSA w/Bipap	13 (4 - 21)	21 (7 - 27)	8	0.007*
OSA	4 (4 - 5.75)	6 (4 - 12.75)	2	0.027*
ACE
OSA w/Bipap	75 (67 - 77)	85 (77 - 92)	10	0.028*
OSA	80 (71.5 - 84.7)	80 (79.2 - 91.5)	0	0.061
FAB
OSA w/Bipap	10 (5.2 - 14.2)	12.5 (8.7 - 14.5)	2.5	0.223
OSA	11 (10 - 13.75)	14.5 (8.7 - 17)	3.5	0.141
DSF
OSA w/Bipap	6 (5 - 7)	6 (5 - 7)	0	0.317
OSA	5 (3.5 - 6.7)	5.5 (5 - 6.7)	0.5	0.414
DSB
OSA w/Bipap	4 (3 - 4)	4 (3 - 5)	0	0.518
OSA	3 (2.25 - 4)	3 (3 - 4)	0	0.564

Table 2. Comparison at Baseline and 30 Days

Baseline

Day 30

Absolute change (Day 30-Baseline)

p-Value

Comparison at Baseline and 30 Days in the OSA With BiPAP Group and in the OSA Without BiPAP Treatment (Intragroup Comparison) in the Following Scales: Functional Independence Measure, Barthel Index, Fugl-Meyer Motor Assessment Upper and Lower Extremities, Addenbroke’s Cognitive, Examination, Frontal Assessment Battery, Digit Span Subtest of the Wechsler Memory Test. Data are presented as median (percentiles 25-75) unless otherwise stated; * Statistical Significance.

FIM

OSA w/Bipap

43 (24.5 - 50.5)

61 (57 - 91.5)

0.001*

OSA

44 (23 - 49)

70 (38.5 - 75.7)

0.002*

OSA w/Bipap

5 (0 - 25)

50 (12.5 - 57.5)

0.001*

OSA

7.5 (0 - 15)

27.5 (5 - 43.7)

0.003*

FMUE

OSA w/Bipap

5 (4 - 31)

24 (4 - 47)

0.018*

OSA

4 (4 - 4)

4 (4 - 6.75)

0.041*

FMLE

OSA w/Bipap

13 (4 - 21)

21 (7 - 27)

0.007*

OSA

4 (4 - 5.75)

6 (4 - 12.75)

0.027*

ACE

OSA w/Bipap

75 (67 - 77)

85 (77 - 92)

0.028*

OSA

80 (71.5 - 84.7)

80 (79.2 - 91.5)

0.061

FAB

OSA w/Bipap

10 (5.2 - 14.2)

12.5 (8.7 - 14.5)

2.5

0.223

OSA

11 (10 - 13.75)

14.5 (8.7 - 17)

3.5

0.141

DSF

OSA w/Bipap

6 (5 - 7)

0.317

OSA

5 (3.5 - 6.7)

5.5 (5 - 6.7)

0.5

0.414

DSB

OSA w/Bipap

4 (3 - 4)

4 (3 - 5)

0.518

OSA

3 (2.25 - 4)

3 (3 - 4)

0.564

**Table 3.** Comparison Between OSA with BiPAP Group Versus OSA Without BiPAP Group
	OSA w/BiPAP	OSA	Absolute change	p-value
Comparison Between OSA with BiPAP Group Versus OSA Without BiPAP Group (Intergroup Comparison) in the Following Scales: Functional Independence Measure, Barthel Index, Fugl-Meyer Motor Assessment Upper and Lower Extremities, Addenbroke’s Cognitive Examination, Frontal Assessment Battery, Digit Span Subtest of the Wechsler Memory Test in Treatment and Control Groups Data are presented as median (percentiles 25-75) unless otherwise stated; * Statistical Significance comparison between groups OSA w/BIPAP and OSA.
FIM
Baseline day	43 (24.5 - 50.5)	44 (23 - 49)
Day 30	61 (57 - 91.5)	70 (38.5 - 75.7)
BI
Baseline	5 (0 - 25)	7.5 (0 - 15)
Day 30	50 (12.5 - 57.5)	27.5 (5 - 43.7)
FMUE
Baseline	5 (4 - 31)*	4 (4 - 4)*	1	*p = 0.027
Day 30	24 (4 - 47)	4 (4 - 6.75)	20	*p = 0.05
FMLE
Baseline	13 (4 - 21)*	4 (4 - 5.75)*	9	*p = 0.011
Day 30	21 (7 - 27)*	6 (4 - 12.75)*	19	*p = 0.019
ACE
Baseline	75 (67 - 77)	80 (71.5 - 84.7)
Day 30	85 (77 - 92)	80 (79.2 - 91.5)
FAB
Baseline	10 (5.2 - 14.2)	11 (10 - 13.75)
Day 30	12,5 (8.7 - 14.5)	14.5 (8.7 - 17)
DSF
Baseline	6 (5 - 7)	5 (3.5 - 6.7)
Day 30	6 (5 - 7)	5.5 (5 - 6.7)
DSB
Baseline	4 (3 - 4)	3 (2.25 - 4)
vDay 30	4 (3 - 5)	3 (3 - 4)

Table 3. Comparison Between OSA with BiPAP Group Versus OSA Without BiPAP Group

OSA w/BiPAP

OSA

Absolute change

p-value

Comparison Between OSA with BiPAP Group Versus OSA Without BiPAP Group (Intergroup Comparison) in the Following Scales: Functional Independence Measure, Barthel Index, Fugl-Meyer Motor Assessment Upper and Lower Extremities, Addenbroke’s Cognitive Examination, Frontal Assessment Battery, Digit Span Subtest of the Wechsler Memory Test in Treatment and Control Groups Data are presented as median (percentiles 25-75) unless otherwise stated; * Statistical Significance comparison between groups OSA w/BIPAP and OSA.

FIM

Baseline day

43 (24.5 - 50.5)

44 (23 - 49)

Day 30

61 (57 - 91.5)

70 (38.5 - 75.7)

Baseline

5 (0 - 25)

7.5 (0 - 15)

Day 30

50 (12.5 - 57.5)

27.5 (5 - 43.7)

FMUE

Baseline

5 (4 - 31)*

4 (4 - 4)*

*p = 0.027

Day 30

24 (4 - 47)

4 (4 - 6.75)

*p = 0.05

FMLE

Baseline

13 (4 - 21)*

4 (4 - 5.75)*

*p = 0.011

Day 30

21 (7 - 27)*

6 (4 - 12.75)*

*p = 0.019

ACE

Baseline

75 (67 - 77)

80 (71.5 - 84.7)

Day 30

85 (77 - 92)

80 (79.2 - 91.5)

FAB

Baseline

10 (5.2 - 14.2)

11 (10 - 13.75)

Day 30

12,5 (8.7 - 14.5)

14.5 (8.7 - 17)

DSF

Baseline

6 (5 - 7)

5 (3.5 - 6.7)

Day 30

6 (5 - 7)

5.5 (5 - 6.7)

DSB

Baseline

4 (3 - 4)

3 (2.25 - 4)

vDay 30

4 (3 - 5)

3 (3 - 4)