2019
Polysomnography Utilization in Veterans Presenting Acutely with Ischemic Stroke or Transient Ischemic Attack
Koo BB, Sico JJ, Myers LJ, Perkins AJ, Levine D, Miech EJ, Damush TM, Rattray N, Homoya B, Ferguson J, Myers J, Zhang Y, Bravata DM. Polysomnography Utilization in Veterans Presenting Acutely with Ischemic Stroke or Transient Ischemic Attack. Cerebrovascular Diseases 2019, 48: 179-183. PMID: 31722335, DOI: 10.1159/000504406.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaComorbidityFemaleHealth Services AccessibilityHealth StatusHumansIschemic Attack, TransientMaleMiddle AgedPolysomnographyPractice Guidelines as TopicPractice Patterns, Physicians'Predictive Value of TestsPrognosisRisk FactorsSleep Apnea, ObstructiveStrokeTime FactorsUnited StatesUnited States Department of Veterans AffairsVeterans HealthConceptsTransient ischemic attackAcute ischemic strokeObstructive sleep apneaVeterans Administration Medical CenterTreatment of OSAIschemic strokeIschemic attackClinical dataExact testVA Corporate Data WarehouseCerebrovascular risk factorsMixed-effects logistic regressionFisher's exact testCorporate Data WarehouseEffects logistic regressionTwo-sample t-testAcute strokeClinical characteristicsHospital dischargeHeart failureSleep apneaFunctional outcomeRisk factorsUS veteransRecent guidelines
2018
Diagnosing and Treating Sleep Apnea in Patients With Acute Cerebrovascular Disease
Bravata DM, Sico J, Fragoso C, Miech EJ, Matthias MS, Lampert R, Williams LS, Concato J, Ivan CS, Fleck JD, Tobias L, Austin C, Ferguson J, Radulescu R, Iannone L, Ofner S, Taylor S, Qin L, Won C, Yaggi HK. Diagnosing and Treating Sleep Apnea in Patients With Acute Cerebrovascular Disease. Journal Of The American Heart Association 2018, 7: e008841. PMID: 30369321, PMCID: PMC6201384, DOI: 10.1161/jaha.118.008841.Peer-Reviewed Original ResearchConceptsContinuous positive airway pressure usePositive airway pressure useTransient ischemic attackRankin Scale scoreIschemic stroke/transient ischemic attackStroke/transient ischemic attackBackground Obstructive sleep apneaHealth Stroke ScaleIschemic attackScale scoreStroke ScaleIschemic strokeTreat analysisSleep apneaAcute ischemic stroke/transient ischemic attackHealth Stroke Scale scoreNational InstituteContinuous positive airway pressureModified Rankin Scale scoreNeurological functioningNeurological symptom severityRecent ischemic strokeStroke Scale scoreAcute cerebrovascular diseaseAcute ischemic stroke
2017
Development, Validation, and Assessment of an Ischemic Stroke or Transient Ischemic Attack-Specific Prediction Tool for Obstructive Sleep Apnea
Sico JJ, Yaggi HK, Ofner S, Concato J, Austin C, Ferguson J, Qin L, Tobias L, Taylor S, Fragoso C, McLain V, Williams LS, Bravata DM. Development, Validation, and Assessment of an Ischemic Stroke or Transient Ischemic Attack-Specific Prediction Tool for Obstructive Sleep Apnea. Journal Of Stroke And Cerebrovascular Diseases 2017, 26: 1745-1754. PMID: 28416405, PMCID: PMC6006998, DOI: 10.1016/j.jstrokecerebrovasdis.2017.03.042.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overArea Under CurveBrain IschemiaDecision Support TechniquesFemaleHumansIschemic Attack, TransientMaleMiddle AgedPolysomnographyPredictive Value of TestsPrevalencePrognosisReproducibility of ResultsRisk AssessmentRisk FactorsROC CurveSleepSleep Apnea, ObstructiveStrokeSurveys and QuestionnairesTime FactorsUnited StatesConceptsObstructive sleep apneaTransient ischemic attackHigh negative predictive valueEpworth Sleepiness ScaleNegative predictive valueIschemic strokeSleep apneaPresence of OSASleep InventoryPredictive valueSleep Apnea Clinical ScoreValidation study populationHigh blood pressureBody mass indexIschemic attackObserved apneaBerlin questionnaireStroke severityBlood pressureOvernight polysomnographyMass indexRandomized trialsClinical scoresSleep QuestionnaireMedical historyDiagnosing and managing sleep apnea in patients with chronic cerebrovascular disease: a randomized trial of a home-based strategy
Bravata DM, McClain V, Austin C, Ferguson J, Burrus N, Miech EJ, Matthias MS, Chumbler N, Ofner S, Foresman B, Sico J, Vaz Fragoso CA, Williams LS, Agarwal R, Concato J, Klar Yaggi H. Diagnosing and managing sleep apnea in patients with chronic cerebrovascular disease: a randomized trial of a home-based strategy. Sleep And Breathing 2017, 21: 713-725. PMID: 28386781, PMCID: PMC5585280, DOI: 10.1007/s11325-017-1494-5.Peer-Reviewed Original ResearchConceptsContinuous positive airway pressureAuto-titrating continuous positive airway pressureChronic cerebrovascular diseaseTransient ischemic attackSleep apneaCerebrovascular diseaseHypertension controlUsual careControl patientsBlood pressureObstructive sleep apnea treatmentBaseline blood pressurePositive airway pressureBackgroundObstructive sleep apneaSleep apnea treatmentBlood pressure assessmentHome-based strategiesIschemic attackUnattended polysomnographyUndiagnosed OSARandomized patientsAirway pressureCPAP adherenceCPAP useApnea treatment
2016
Observational Study of Obstructive Sleep Apnea in Wake-Up Stroke: The SLEEP TIGHT Study
Koo BB, Bravata DM, Tobias LA, Mackey JS, Miech EJ, Matthias MS, Stahl SM, Sico JJ, Fragoso C, Williams LS, Lampert R, Qin L, Yaggi HK. Observational Study of Obstructive Sleep Apnea in Wake-Up Stroke: The SLEEP TIGHT Study. Cerebrovascular Diseases 2016, 41: 233-241. PMID: 26811929, DOI: 10.1159/000440736.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood PressureBlood Pressure Monitoring, AmbulatoryBrain IschemiaChi-Square DistributionCholesterol, LDLConnecticutCross-Sectional StudiesFemaleHumansIndianaIschemic Attack, TransientLogistic ModelsMaleMiddle AgedOdds RatioOxygenPolysomnographyPrevalenceRandomized Controlled Trials as TopicRisk FactorsSeverity of Illness IndexSex FactorsSleepSleep Apnea, ObstructiveStrokeSympathetic Nervous SystemWakefulnessConceptsObstructive sleep apneaDiastolic blood pressureSevere obstructive sleep apneaLow-density lipoproteinBlood pressureSleep apneaSerum catecholaminesAmbulatory blood pressure monitoringBaseline diastolic blood pressureMean body mass indexB-type natriuretic peptideHigher diastolic blood pressureMore oxygen desaturationTransient ischemic attackIschemic stroke patientsAmbulatory blood pressureHistory of strokeBody mass indexC-reactive proteinBlood pressure monitoringOxygen desaturation eventsGender-stratified analysesCross-sectional analysisIschemic attackOSA frequency
2015
Infarct location and sleep apnea: evaluating the potential association in acute ischemic stroke
Stahl SM, Yaggi HK, Taylor S, Qin L, Ivan CS, Austin C, Ferguson J, Radulescu R, Tobias L, Sico J, Fragoso C, Williams LS, Lampert R, Miech EJ, Matthias MS, Kapoor J, Bravata DM. Infarct location and sleep apnea: evaluating the potential association in acute ischemic stroke. Sleep Medicine 2015, 16: 1198-1203. PMID: 26429745, PMCID: PMC4592521, DOI: 10.1016/j.sleep.2015.07.003.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaApnea-hypopnea indexAcute ischemic strokeIschemic stroke patientsStroke patientsStroke locationOSA presenceIschemic strokeSleep apneaPrevalence of OSASeverity of OSAAcute ischemic stroke patientsTransient ischemic attackObstructive respiratory eventsMeasures of hypoxiaHigh overall prevalenceBrain imaging reportsIschemic attackPolysomnographic findingsOSA severityComplete polysomnographyRespiratory eventsInfarct locationOverall prevalenceVascular territories
2012
Diagnosis and Treatment of Sleep Apnea in patients' homes: the rationale and methods of the "GoToSleep" randomized-controlled trial.
Bravata DM, Ferguson J, Miech EJ, Agarwal R, McClain V, Austin C, Struve F, Foresman B, Li X, Wang Z, Williams LS, Dallas MI, Couch CD, Sico J, Fragoso C, Matthias MS, Chumbler N, Myers J, Burrus N, Dube A, French DD, Schmid AA, Concato J, Yaggi HK. Diagnosis and Treatment of Sleep Apnea in patients' homes: the rationale and methods of the "GoToSleep" randomized-controlled trial. Journal Of Clinical Sleep Medicine 2012, 8: 27-35. PMID: 22334806, PMCID: PMC3266333, DOI: 10.5664/jcsm.1654.Peer-Reviewed Original ResearchConceptsContinuous positive airway pressureAuto-titrating continuous positive airway pressureTransient ischemic attackSleep apneaVeterans Health AdministrationCerebrovascular diseaseControl groupAntihypertensive medicationsIntervention groupPatient's homePressure continuous positive airway pressureUsual care control groupControl of hypertensionPositive airway pressureCare control groupLaboratory-based sleep studiesUndiagnosed sleep apneaBlood pressure assessmentInclusion of patientsRandomized-controlled trialBlood pressure measurementsHome-based polysomnographySleep laboratory polysomnographyOne-year study periodTherapeutic intervention strategies