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PLoS One. 2017 Jan 30;12(1):e0171243. doi: 10.1371/journal.pone.0171243. eCollection 2017.

The Association of Lesion Location and Sleep Related Breathing Disorder in Patients with Acute Ischemic Stroke.

Author information

Department of Neurology, University of Muenster, Muenster, Germany.
Department of Neuroradiology, University of Luebeck, Luebeck, Germany.
Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.
Department of Sleep Medicine and Neuromuscular Disorders, Muenster, Germany.



Sleep related breathing disorders (SRBD) are common in patients with ischemic stroke and are associated with poor outcome. SRBD after stroke were assumed to be a direct consequence of injury of specific central nervous system structures. However, whether specific locations of ischemic infarcts cause SRBD is yet unknown. We therefore investigated the association of ischemic lesion location with SRBD.


Patients with acute ischemic stroke treated on our stroke unit were included in a prospective observational study. All patients underwent magnetic resonance imaging (MRI) and polygraphy in the acute phase after stroke. SRBD was defined by an apnea-hypopnea index (AHI) ≥10. MRI were evaluated using standardized maps to depict voxel-wise probability distribution of infarction for patients with and without SRBD. Groups were compared using logistic regression analysis.


Of 142 patients included, 86 (59%) had a SRBD. Age, body mass index and prevalence of arterial hypertension were significantly higher in patients with SRBD. There was no statistically significant association between any lesion location and SRBD.


We found no association of lesion location and SRBD in stroke patients, whereas established risk factors for SRBD, known from general population, were significantly associated with SRBD. Given the high prevalence of SRBD in stroke patients, these findings suggest that cerebral ischemia facilitates the occurrence of SRBD in patients with pre-existing risk factors rather than causing it by damaging specific central nervous system structures. Our findings can be used to identify stroke patients who might benefit from polygraphy screening.

[Indexed for MEDLINE]
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Conflict of interest statement

Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: PY received honoraries for invited talks and advisory boards meetings from Heinen und Löwenstein, ResMed, UCB, GENZYME, Medice and Vanda. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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