Stroke is the leading cause of adult disability in the US and the third leading cause of death. More than half of ischemic stroke patients have sleep apnea, a very common and important risk factor for incident stroke and potentially a risk factor for poor stroke outcome. No published studies have established the prevalence of sleep apnea in Hispanics to discern sleep apnea's contribution to excess stroke burden in this large minority group. Small studies conducted in academic medical centers have suggested that stroke patients with sleep apnea have particularly poor stroke outcomes, but population-based studies in diverse populations are lacking. Even fewer data exist about the relationship between sleep apnea and recurrent stroke and mortality, potential targets for a clinical trial of sleep apnea treatment in stroke patients. The parent study for this project, the Brain Attack Surveillance in Corpus Christi (BASIC) project, is an ongoing population-based stroke surveillance study that identifies stroke cases in Nueces County, Texas. This study has made many important discoveries about stroke in Hispanics, the largest minority group in the US, and non-Hispanic whites. BASIC, which was recently renewed for another 5 years (February, 2009 - January, 2014), will continue to identify all ischemic strokes in Nueces County and will provide detailed 90-day stroke outcome data (cognitive, functional, neurologic, and quality of life). In the current proposal we add ancillary studies to this project including physiological and questionnaire-based sleep apnea screening in the acute stroke period. We propose to relate these data to 90-day outcomes and long term stroke recurrence and death risk. Given that outcome assessment is currently underway and will cease in March 31, 2013, it is critical to begin sleep apnea screening as soon as possible to maximize the power for the given study objectives. The ancillary studies will allow us to answer important, novel questions about sleep-disordered breathing and its relationship to stroke and stroke outcomes within a bi-ethnic community in a cost-containing fashion, as we will use the BASIC infrastructure for case identification and outcome data collection. This proposal seeks to understand the influence of a very frequent risk factor, sleep apnea, on a common, devastating disease, stroke, in the largest and fastest growing US minority population.

Public Health Relevance

Sleep apnea is an important predictor of poor outcomes after stroke. Using the preexisting infrastructure of the BASIC project, the current proposal will allow for the rigorous study of the epidemiology of sleep apnea after stroke in non-Hispanic whites and Hispanics, the largest minority in the United States.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL098065-04
Application #
8487434
Study Section
Special Emphasis Panel (ZHL1-CSR-G (O2))
Program Officer
Twery, Michael
Project Start
2010-06-01
Project End
2014-03-31
Budget Start
2013-04-01
Budget End
2014-03-31
Support Year
4
Fiscal Year
2013
Total Cost
$366,389
Indirect Cost
$130,769
Name
University of Michigan Ann Arbor
Department
Neurology
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Brown, Devin L; Mowla, Ashkan; McDermott, Mollie et al. (2015) Ischemic stroke subtype and presence of sleep-disordered breathing: the BASIC sleep apnea study. J Stroke Cerebrovasc Dis 24:388-93
Rundek, Tatjana; Brown, Devin L (2014) Socioeconomic status and subclinical atherosclerosis: are we closing disparity gaps? Stroke 45:948-9
Brown, Devin L; McDermott, Mollie; Mowla, Ashkan et al. (2014) Brainstem infarction and sleep-disordered breathing in the BASIC sleep apnea study. Sleep Med 15:887-91
De Lott, Lindsey B; Lisabeth, Lynda D; Sanchez, Brisa N et al. (2014) Prevalence of pre-stroke sleep apnea risk and short or long sleep duration in a bi-ethnic stroke population. Sleep Med 15:1582-5
Zahuranec, Darin B; Lisabeth, Lynda D; Sánchez, Brisa N et al. (2014) Intracerebral hemorrhage mortality is not changing despite declining incidence. Neurology 82:2180-6
Kerber, Kevin A; Zahuranec, Darin B; Brown, Devin L et al. (2014) Stroke risk after nonstroke emergency department dizziness presentations: a population-based cohort study. Ann Neurol 75:899-907
Woo, Daniel; Falcone, Guido J; Devan, William J et al. (2014) Meta-analysis of genome-wide association studies identifies 1q22 as a susceptibility locus for intracerebral hemorrhage. Am J Hum Genet 94:511-21
Brown, Devin L; Chervin, Ronald D; Hegeman 3rd, Garnett et al. (2014) Is technologist review of raw data necessary after home studies for sleep apnea? J Clin Sleep Med 10:371-5
Lisabeth, Lynda D; Sánchez, Brisa N; Baek, Jonggyu et al. (2014) Neurological, functional, and cognitive stroke outcomes in Mexican Americans. Stroke 45:1096-101
Reeves, Sarah L; Brown, Devin L; Chervin, Ronald D et al. (2014) Agreement between stroke patients and family members for ascertaining pre-stroke risk for sleep apnea. Sleep Med 15:121-4

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