ArticleStroke2021
Overnight Rostral Fluid Shifts Exacerbate Obstructive Sleep Apnea After Stroke.
Article in Stroke, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Physical activity for obstructive sleep apnea after stroke? A pilot study assessing the contribution of body fluids.Sleep & breathing = Schlaf & Atmung · 2023Trial
- Obstructive Sleep Apnea Syndrome and Ischemic Stroke: Investigating Inflammatory Mechanisms.Nature and science of sleep · 2026Review
- Modafinil for Promoting Wakefulness in Critically Ill Patients: Current Evidence and Perspectives.Clocks & sleep · 2025Review
- Longitudinal Assessment of Sleep Apnea in the Year After Stroke in a Population-Based Study.Stroke · 2023Article
- The J-shape Association between Total Bilirubin and Stroke in Older Patients with Obstructive Sleep Apnea Syndrome: A Multicenter Study.The journal of nutrition, health & aging · 2023Article
- Impact of Body Composition on Sleep and Its Relationship with Sleep Disorders: Current Insights.Nature and science of sleep · 2023Review
- Associations between air pollution, intracellular-to-extracellular water distribution, and obstructive sleep apnea manifestations.Frontiers in public health · 2023Article
- Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship.Current neurology and neuroscience reports · 2022Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
Background and Purpose: Overnight shifts of fluid from lower to upper compartments exacerbate obstructive sleep apnea (OSA) in some OSA populations. Given the high prevalence of OSA after stroke, decreased mobility and use of IV fluids among hospitalized patients with stroke, and improvement in OSA in the months after stroke, we hypothesized that overnight fluid shifts occur and are associated with OSA among patients with subacute ischemic stroke. Methods: Within a population-based project, we performed overnight sleep apnea tests (ApneaLink Plus) during ischemic stroke hospitalizations. Before sleep that evening, and the following morning before rising from bed, we assessed neck and calf circumference, and leg fluid volume (bioimpedance spectroscopy). The average per subject overnight change in the 3 fluid shift measurements was calculated and compared with zero. Linear regression was used to test the crude association between each of the 3 fluid shift measurements and the respiratory event index (REI). Results: Among the 292 participants, mean REI was 24 (SD=18). Within individuals, calf circumference decreased on average by 0.66 cm (SD=0.75 cm, P<0.001), leg fluid volume decreased by a mean of 135.6 mL (SD=132.8 mL, P<0.001), and neck circumference increased by 0.20 cm (SD=1.71 cm, P=0.07). In men, when the overnight change of calf circumference was negative, an interquartile range (0.8 cm) decrease in calf circumference overnight was significantly associated with a 25.1% increase in REI (P=0.02); the association was not significant in women. The relationship between overnight change in leg fluid volume and REI was U shaped. Conclusions: This population-based, multicenter, cross-sectional study showed that in hospitalized patients with ischemic stroke, nocturnal rostral fluid shifts occurred, and 2 of the 3 measures were associated with greater OSA severity. Interventions that limit overnight fluid shifts should be tested as potential treatments for OSA among patients with subacute ischemic stroke.
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Registered trials
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