Central periodic breathing during sleep in acute ischemic stroke

Background and Purpose - It has been suggested that central periodic breathing during sleep (CPBS) may develop in unilateral supratentorial stroke without cardiopulmonary disease and disturbed consciousness. Not many data existed about such patients. Methods - Of 31 patients with first-ever stroke, we report 3 patients with CPBS in the absence of cardiopulmonary and vigilance disturbances. Patient assessments included polysomnography, MRI and echocardiography. Nocturnal breathing was reassessed after 1 to 3 months. Results - The patients had ischemic strokes in the left cingulate cortex, left insula and right paramedian thalamus. They were fully conscious when submitted to sleep recordings and lacked overt cardiovascular dysfunctions ( ejection fractions=67%, 48%, 65%). CPBS was present during 18% to 24% of sleep. In all patients, breathing improved during stroke recovery. Conclusions - CPBS may be present in strokes involving autonomic ( insula) and volitional ( cingulate cortex, thalamus) respiratory networks. As such, CPBS partly resolves within weeks.