sleep apnea, brainstem stroke, infarction, sleep disordered breathing

BACKGROUND: Association between cerebral infarction site and poststroke sleep-disordered breathing (SDB) has important implications for SDB screening and the pathophysiology of poststroke SDB. Within a large, population-based study, we assessed whether brainstem infarction location is associated with SDB presence and severity. METHODS: Cross-sectional study was conducted on ischemic stroke patients in the Brain Attack Surveillance in Corpus Christi (BASIC) project...

OBJECTIVE: To investigate nocturnal sleep breathing disturbance in patients with ischemic cerebral stroke. METHODS: Forty-one patients with cerebral infarction undertook all-night screening of sleep breathing. The clinical features between cerebral infarction concomitant with mild and severe sleep breathing disturbance were compared, and the effects of different infarcted sites and sizes, the infarction history and symptoms on the breathing disorders were analyzed...

Central sleep apnoea (CSA) is a breathing disorder characterized by repetitive central apnoeas with hypoxia interrupted by hyperventilation phases. In the literature, there are reports of CSA caused by brainstem infarcts. We report two patients (38 and 53 years old) with longstanding history of central sleep apnoea who died during sleep. In both cases the autopsy revealed acute bilateral hypoxic lesions at the level of the solitary tract nuclei. In one case, symmetrical selective neuronal necrosis was found in the dorsal part of the solitary tract nuclei...

Four basic control mechanisms of breathing (brainstem respiratory centre, peripheral and central chemoreceptors, intero- and exteroceptive reflexes and suprapontine influences), as well as their sleep-related disorders are analysed. A decrease in central chemoreceptor sensitivity to CO2 and an increase in upper airway resistance during sleep result in hypoventilation and mild hypoxaemia already in physiological conditions. Compensatory increase in ventilatory effort with synchronous inhibition of pharyngeal dilators during sleep reduces the upper airway lumen manifesting with snoring, upper airway resistance syndrome, and OSA...

Medullary disorders can be associated with a sleep apnea syndrome. The present patient developed a sleep apnea syndrome with approximately 25 episodes of apnea or hypopnea during each hour of sleep following a lateral medullary infarction. The presence of predisposing factors and involvement of respiratory centers in the area of the medullary lesion may determine the appearance of sleep apnea with brainstem infarction. Investigation of breathing during sleep may be helpful in such cases.