Screening for Sleep Disordered Breathing in Three Distinct Neurological Diseases in the Bulgarian Population

Abstract

Sleep disordered breathing (SDB) is a common medical problem in the general population. Neurological disorders such as ischemic stroke (IS), myasthenia gravis (MG), or multiple sclerosis (MS) seem to be of higher risk of SDB. Nevertheless, the implementation of screening for SDB in such disorders has not been well studied. Therefore, the aim of this study was to explore screening parameters for SDB in IS, MG and MS, in our region. We included prospectively patients with diagnosed IS, MG and MS. Psychometric tools such as the Epworth Sleepiness Scale (ESS), the STOP-BANG, and the Berlin questionnaire were implemented. For the respiratory screening portable recording device was used. Seventy-two patients, 25 with IS (mean age 66.3 years), 24 with MG (mean age 47.9 years), and 23 with MS (mean age 40.1 years) were enrolled. Basic anthropometric parameters such as BMI, neck and waist circumference were higher in IS than in MG and MS ($$p<0.001$$). The ESS scores were 5.5±3.2 for IS, 5.6±3.3 for MG, and 5.9±4.5 for MS, but without significant difference between the groups. Contrariwise, STOP-BANG scores in IS were 4.8±1.3, significantly higher ($$p<0.0001$$) than both MG (2.1±1.4) and MS (1.2±0.9). A high risk for OSA in BQ was calculated in 68% of IS, much higher ($$p<0.0001$$) than in MG (33.3%) and in MS (13%). In the respiratory screening, the mean apnea-hypopnea index in the IS group (20±18.3) was statistically higher than in MG (8.1±12.7, $$p<0.005$$), and in MS patients (2.3±4.9, $$p<0.001$$). Oxygen desaturation index in IS (19.3±19) differed statistically from the one in MG (8.1±12.9, $$p<0.005$$), and in MS (2.6±5.5, $$p<0.001$$). The oxygen saturation (SO2) showed difference only between IS and MS in all three measured values – baseline SO2 ($$p<0.001$$), median SO2 ($$p<0.05$$) and lowest SO2 ($$p<0.05$$). IS, MG and MS, as distinct neurological entities, show different clinical profiles with respect to screening for SDB. These should be taken into consideration in the individual evaluation for sleep disordered breathing.