B. Clinical Sleep Science and Practice X.

Sleep and Neurologic Disorders

1149 Methods: Retrospective cohort analysis utilizing in-lab PSG sleep

A PILOT QUALITY IMPROVEMENT (QI) STUDY TO study data conducted among older adults between 2001 and 2005.
ASSESS WHETHER BILEVEL POSITIVE AIRWAY OSA was defined using AHI4%. Participants had no history of
PRESSURE (BIPAP) SUPPORT IN ACUTE ISCHEMIC cognitive decline or AD at baseline and included 663 (284 Non-
STROKE PATIENTS WITH SLEEP DISORDERED Hispanic White (NHW), 207 Black/African-American (AA) and
BREATHING, CAN IMPROVE NEUROLOGICAL 172 Hispanic) OSA-patients matched on age, sex, race, BMI, 1:1
RECOVERY DURING ACUTE STROKE CARE ratio to 663 (unexposed cohort I from sleep clinic) and 1:4 ratio to
2652 (unexposed cohort II from non-sleep clinics) non-OSA indi-

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Nadhim, A. N.1 wong, J.1 Gupta, D.1 Suhan, L.1 Siegel, M.1
Bhat, S.1 strauss, S.1 Fourcard, F.3 Pandya, V.3 viduals. Incident AD was assessed annually from 2001-2013 with
1 ICD-9-CM code 331.0. Adjusted cox proportional hazard regres-
JFK Neuroscience institute, Edison, NJ, 2JFK Neuroscience
sion models examined race and sex-specific biologic mechanisms
institute, Edison, NJ, 3JFK Neuroscience institute, perth amboy, NJ.
including hypoxia, fragmentation and duration measures of OSA
Introduction: Obstructive sleep apnea (OSA) has been associ- and AD risk.
ated with adverse outcomes in patients with stroke. While data Results: Of the 3,978 participants, 2,148 (54%) were women. Mean
is limited, it suggests that treatment of OSA may improve neuro- age at baseline was 72.6 (7.3) years. Over a mean follow-up time of
logical recovery. With this quality improvement (QI) project, we 8.6 (1.4) years, 358 (9%) individuals (212 female) developed AD
aim to develop an interprofessional-team workflow process for (119 NHW, 134 AAs, and 105 Hispanics). Relative to non-OSA
screening and correction of OSA in acute ischemic stroke, with the individuals, OSA-patients had a higher risk of incident AD, with
goal to improve outcomes of neurological recovery. AAs and females showing stronger risk estimates (aHR: 2.24, 1.83,
Methods: This is an ongoing study to screen all eligible patients and 1.73, P <.001 for all, for AAs, Hispanics and NHW respect-
admitted to JFK Medical Center stroke unit, with MRI-proven ively; and aHR: 2.38, and 1.37, P <.001 for all, for female and male
Supratentorial acute ischemic stroke. The patients are screened respectively). Measures of hypoxia, sleep fragmentation and sleep
using an overnight Pulse Oximetry test. A 3% oxygen desaturation duration were associated with increase AD risk (P <.01 for all).
index (ODI) of ≥10/hr or 4% ODI of ≥ 5/hr is considered at high Relative to NHW, AAs and Hispanics demonstrated up to 20%
risk for OSA. Such Patients will receive nocturnal Auto-adjusting stronger effects/estimates on hypoxia and sleep duration measures.
BIPAP therapy during their acute care stay, for up to 5 days, for Relative to males, females demonstrated up to 25% stronger ef-
at least 4 hours per night. Eligible Patients who refused BiPAP fects/estimates on sleep fragmentation measures, and 15% weaker
therapy or were non-compliant will be considered as a controls. effects/estimates on hypoxia measures (P <.01 for all).
Baseline NIH stroke scale (NIHSS), and bilateral MCA mean flow Conclusion: Among OSA-patients, mechanisms related to hyp-
velocity (MFV) in the morning, by transcranial doppler (TCD) oxia, sleep fragmentation and duration measures increase AD risk
will be assessed at baseline for cases and controls, and after BiPAP and may underlie race/ethnicity and sex disparities in AD.
therapy, for the case group. The two groups of patients will also be Support: NIH/NIA/NHLBI (L30-AG064670, CIRAD
compared in terms of Modified Rankin Scale at time of discharge P30AG059303 Pilot, T32HL129953, R01HL118624,
and at phone follow-up after 6 weeks. R21AG049348, R21AG055002, R01AG056031, R01AG022374,
R21AG059179, R01AG056682, R01AG056531, K07AG05268503,
Results: Between Oct 17th, 2019 to current, 15 patients were ad-
K23HL125939)
mitted to the stroke unit with MRI confirmed stroke. Ages ranged
from 34 - 88 years (average age 66.5 years). 8 patients (60%) were
female. Of those, 6 patients consented to being screened for OSA. 1151
Of these, 1 had 4%ODI >5/hr, and therefore received treatment with IS TIMING OF LIGHT EXPOSURE DIFFERENT IN
BIPAP. However, compliance was < 4 hrs on 2 consecutive nights. WOMEN WITH CHRONIC MIGRAINE?
Conclusion: This is ongoing QI project and results will be available Dawson, S. C.1 Kim, M.1 Reid, K.1 Burgess, H. J.2 Wyatt, J. K.3
after few more months of continued recruitment. Hedeker, D.4 Park, M.5 Rains, J. C.6 Espie, C. A.7 Taylor, H. L.8
Support: Auto-adjusting BIPAP machines were provided by Ong, J. C.1
RESMED. 1
Department of Neurology, Northwestern University, Chicago,
IL, 2Department of Psychiatry, University of Michigan, Ann
1150 Arbor, MI, 3Rush University Medical Center, Chicago, IL,
OBSTRUCTIVE SLEEP APNEA-DEPENDENT RACIAL/ 4
University of Chicago, Chicago, IL, 5Chicago Sleep Health,
ETHNIC AND SEX-SPECIFIC MECHANISMS Advocate/Illinois Masonic Hospital, Chicago, IL, 6Center for
UNDERLYING ALZHEIMER’S DISEASE RISK: Sleep Evaluation, Elliot Hospital, Manchester, NH, 7Nuffield
A RETROSPECTIVE COHORT ANALYSIS OF IN-LAB PSG
Department of Clinical Neurosciences, University of Oxford,
SLEEP STUDY DATA
Oxford, UNITED KINGDOM, 8The Maine Sleep Center at
Bubu, O. M.1 Turner, A. D.1 Parekh, A.2 Mullins, A.2 Kam, K.2
Chest Medicine Associates, South Portland, ME.
Umasabor-Bubu, O. Q.3 Mbah, A. K.4 Williams, N. J.1
Varga, A. W.2 Rapoport, D. M.2 Ayappa, I.2 Jean-Louis, G.1 Introduction: Light avoidance is a common coping behavior of in-
Osorio, R. S.1 dividuals with migraine headaches. It is not known whether timing
1
NYU School of Medicine, New York, NY, 2Icahn School of Medicine of light exposure is different in individuals with chronic migraine
at Mount Sinai, New York, NY, 3SUNY Downstate Medical Center, (CM) compared to those without migraine and how this may relate
Brooklyn, NY, 4University of South Florida, Tampa, FL. to headache frequency and severity. We tested this by examining
timing of the brightest and darkest light and headaches in women
Introduction: We examined race and sex-specific biologic mech- with chronic migraines and healthy controls.
anisms of the relationship between obstructive sleep apnea (OSA) Methods: Sixteen women with CM (mean age = 33.07) and 18
and incident AD. female healthy controls (HC; mean age = 32.22) completed daily

SLEEP, Volume 43, Abstract Supplement, 2020 A438