Objectives EndoPAT-derived reactive hyperemia index (RHI) is used to assess peripheral endothelial dysfunction, but its clinical value after acute ischemic stroke remains uncertain. We aimed to evaluate whether low RHI was associated with functional outcomes, early neurological deterioration (END), 3-month clinical events, and incremental outcome prediction. Materials and Methods This was a retrospective analysis of a prospectively maintained single-center acute stroke registry. Patients were followed through discharge and 3 months after the index stroke. Among 373 patients with a final diagnosis of acute ischemic stroke, 357 had valid RHI measurements and were included in the EndoPAT analysis. Low RHI was defined as RHI ≤1.67. Logistic regression models were adjusted for age, sex, TOAST subtype, premorbid modified Rankin Scale (mRS), initial NIHSS, and vascular risk factors. Receiver operating characteristic analyses compared conventional outcome models with and without continuous RHI. Results Low RHI was present in 152 patients (42.6%). Poor discharge outcome occurred in 49/149 patients with low RHI and 51/204 with normal RHI (32.9% vs 25.0%; P=0.104). Low RHI was associated with poor discharge outcome after full adjustment (adjusted odds ratio 1.82, 95% CI 1.04-3.18; P=0.036). Poor 3-month outcome occurred in 36/141 patients with low RHI and 35/191 with normal RHI (25.5% vs 18.3%; P=0.113) and was not significant after adjustment (adjusted odds ratio 1.55, 95% CI 0.84-2.85; P=0.158). Low RHI was not associated with END or 3-month clinical events. Adding continuous RHI minimally changed AUC for discharge outcome (0.792 to 0.793) and 3-month outcome (0.771 to 0.776). Conclusions Low pre-discharge RHI was associated with poor discharge functional outcome, but showed limited association with longer-term outcome, clinical events, or incremental prediction. These findings support interpreting RHI as an in-hospital clinical marker, not as an independent prognostic test.

Thromboelastography (TEG) characterizes whole-blood clot kinetics and strength at a single time point. We examined the concurrent association of early subacute TEG parameters with functional status at discharge after acute ischemic stroke. TEG was performed 5–7 days after admission, and the analyses included 372 patients with acute ischemic stroke. Because the TEG 5000 and TEG 6s are not directly interchangeable, each parameter was standardized within platform. The primary outcome was discharge modified Rankin Scale (mRS) 3-6. In multivariable models (N=356; 106 events), each platform-specific 1-SD increase in alpha angle was associated with poor discharge status (adjusted odds ratio [OR], 1.45; 95% confidence interval [CI], 1.03-2.04; p=0.032), as was MA (adjusted OR, 1.84; 95% CI, 1.32-2.59; p<0.001). The MA association persisted within both platforms and after adjustment for discharge antiplatelet and anticoagulant prescriptions. Associations with 3-month functional status were not statistically significant, although the estimates remained in the same direction. Higher alpha angle and MA measured 5–7 days after admission were associated with poor functional status at discharge, particularly for MA, suggesting that these TEG parameters may reflect an in-hospital hemostatic state related to short-term functional status.

Background and Purpose The Generalized Anxiety Disorder 7-item (GAD-7) is a self-report questionnaire assessing anxiety-related symptoms experienced over the past two weeks. The GAD-7 is widely used to screen for generalized anxiety disorder (GAD), and reported optimal cutoff scores for detecting GAD in people living with epilepsy (PLWE) range between >6 and >9. This meta-analysis aims to determine the most appropriate GAD-7 cutoff score for PLWE. Methods We identified relevant studies through comprehensive searches in MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus. Studies included original research examining GAD-7 accuracy for detecting GAD in adult PLWE, using structured diagnostic interviews including the Mini International Neuropsychiatric Interview as a reference standard. Only studies providing sufficient data for meta-analysis were included, including the number of PLWE with GAD, the total participant number, sensitivity, and specificity. We performed summary receiver operating characteristic curve analyses. Results Seven studies conducted in outpatient epilepsy clinics were included. The area under the curve (AUC) ranged between 0.91 and 0.96 across cutoff scores from >5 to >9. The cutoff score of >6 provided the best balance of diagnostic accuracy, with an AUC of 0.96, sensitivity of 0.95, and specificity of 0.83. Conclusions The GAD-7 cutoff score of >6 has optimal diagnostic performance for screening GAD in PLWE. These results offer valuable guidance for clinicians and researchers applying the GAD-7 questionnaire to detect GAD among PLWE, especially in geographic areas without previously validated language-specific versions.

BACKGROUND AND PURPOSE:Neuronal intranuclear inclusion disease (NIID) is a progressive neurodegenerative disease characterized by a wide range of clinical manifestations. GGC-repeat expansion in NOTCH2NLC was recently identified as the genetic cause of NIID. Here we report clinical, radiological, pathological, and genetic findings in NIID patients. METHODS:Twenty-five NIID patients from 22 unrelated families of Korean ancestry were reviewed from 9 referral centers in South Korea. We compared clinical features between sporadic and familial NIID patients. We classified NIID patients according to their prominent symptoms. The presence of GGC repeat expansion was analyzed in 19 patients. RESULTS:The 25 reviewed NIID patients comprised 12 (48.0%) sporadic and 13 (52.0%) familial cases, with the latter showing a significantly higher proportion of males (p=0.027). The patients were classified into three subtypes based on the prominent symptoms: NIID-Episodic (44.0%), NIID-EPS (extrapyramidal symptoms) (36.0%), and NIID-Dementia (20.0%). Most patients (92.0%) also exhibited other symptoms, including peripheral neuropathy (60.0%), bladder dysfunction (48.0%), or ophthalmic problems (56.0%). Hyperintensities along the corticomedullary junctions in diffusion-weighted imaging and extensive white-matter hyperintensities in fluid-attenuated inversion-recovery imaging were observed in 96.0% and 100% of the patients, respectively. GGC repeat expansion in NOTCH2NLC was identified in 6 sporadic and 10 familial cases. The number of GGC repeats was not correlated with the onset age or clinical symptoms. CONCLUSIONS:This study has highlighted the diverse phenotypes and genetic profiles of Korean NIID patients, and provided valuable insights into this rare disorder.

Frailty is a state of vulnerability to poor homeostatic resolution of after a stressful event. The prevalence of frailty in patients with chronic kidney disease (CKD) is more common than in the general population. Frailty is associated with a poor clinical prognosis, malnutrition, and cognitive impairment; however, studies on these factors in patients with CKD are lacking. Therefore, we aimed to evaluate the relationship between CKD and frailty, nutritional status, and cognitive impairment and their influence on clinical outcomes. We prospectively enrolled participants from June 2019 to December 2020 and divided them into three CKD groups according to kidney function (CKD G1-2, CKD G3-4, and CKD G5D). Clinical outcomes were defined as the composite outcomes of all-cause death, hospitalization, and cardiovascular outcomes, including nonfatal myocardial infarction, revascularization, or stroke. To calculate the relative risk of frailty, cognitive impairment, nutritional status, and clinical outcome, odds ratios (ORs) and 95

We previously conducted a retrospective analysis of polysomnography (PSG) electrocarttiography (ECG) data to classify obstructive sleep apnea (OSA) using deep learning analysis (DLA). The study achieved a ROC AUC score of 0.7077 and an F1 score of 0.67, demonstrating its potential as a screening tool for OSA. In this study, we further analyzed oximetry data extracted from PSG and explored the integration of ECG- and oximetry-based screening tools into vital sign monitoring devices within the stroke intensive care unit (SU) to evaluate their clinical utility in real-world settings. We retrospectively analyzed PSG data collected between 2015 and 2023. OSA was classified into two categories: normal/mild and moderate/severe, based on the apnea-hypopnea index (AHI). For DLA, oximetry data were converted into Mel-spectrograms and analyzed using a Convolutional Neural Network, generating a confusion matrix. Additionally, we assessed the utility of the screening tool in patients admitted to the SU between January and October 2024. PSG was conducted for patients meeting the following criteria: STOP-BANG score ≥3, witnessed snoring or apnea, and a Modified Mallampati Score ≥3. Out of 1,806 PSG records, 252 cases with arrhythmias were excluded, leaving 1,554 records for analysis. OSA was classified as normal/mild in 616 cases and moderate/severe in 938 cases. The DLA results for oximetry yielded a ROC AUC score of 0.7814 and an F1 score of 0.79. In the SU cohort, 211 patients were evaluated. After excluding 34 cases with arrhythmias and 67 instances of data loss, 110 patients remained. Among these, 49.5% had a STOP-BANG score ≥3, 40.4% were suspected of having OSA based on oximetry data, and 60.6% based on ECG data. Among the five patients who underwent final PSG testing, oximetry demonstrated an accuracy of 80%, while ECG achieved 100%. Our findings suggest that DLA using oximetry showed higher accuracy in retrospective PSG data compared to ECG. However, in the SU setting, oximetry faced challenges due to variations in sampling rates across devices. In contrast, ECG data demonstrated more consistent sampling rates, providing a clinical advantage. Further studies are warranted to validate and optimize both approaches for widespread application.

INTRODUCTION:Sarcopenia, characterized by reduced skeletal muscle mass (RMM), is increasingly recognized as a significant factor influencing outcomes in various health conditions, including stroke. Although most studies focus on sarcopenia developing during stroke rehabilitation, the impact of sarcopenia present at the onset of acute ischemic stroke remains underexplored. This study aims to evaluate the effect of RMM at stroke onset on 3-month functional outcomes in acute ischemic stroke patients. MATERIALS AND METHODS:We prospectively enrolled acute ischemic stroke patients admitted between May 2019 and December 2019. Muscle mass was accessed early during hospitalization using whole-body dual-energy X-ray absorptiometry (DXA), and patients were categorized into RMM and normal muscle mass (NMM) groups based on the Asian Working Group for Sarcopenia (AWGS) criteria. Functional outcomes at 3 months were assessed using the modified Rankin Scale (mRS), with unfavorable outcomes defined as mRS scores 2-5. Multivariable logistic regression and SHAP (Shapley Additive exPlanations) analyses were used to evaluate the independent impact of RMM on 3-months functional outcomes. RESULTS:A total of 99 patients were analyzed. The RMM group had a significantly higher prevalence of unfavorable outcomes at 3 months compared to the NMM group (p < 0.001). Patients with RMM were older and presented with more severe strokes. Multivariable analysis confirmed RMM as an independent predictor of unfavorable outcomes (adjusted OR: 8.07, 95% CI: 1.603-40.66, p = 0.011), even after adjusting for age and initial stroke severity. SHAP analysis ranked RMM as the second most influential predictor of unfavorable outcomes, following NIHSS on admission. These findings indicate that RMM not only worsens initial stroke severity but also independently hinders post-stroke recovery. CONCLUSIONS:Reduced muscle mass at the onset of acute ischemic stroke is a significant, independent predictor of unfavorable outcomes at 3 months. In addition to its impact on recovery, RMM is linked to older age and more severe strokes, worsening prognosis. Maintaining muscle mass is also crucial for stroke prevention, as it supports cardiovascular health and resilience. Early identification and intervention for sarcopenia can improve recovery and reduce future stroke risk.

Obstructive sleep apnea (OSA) presents an elevated risk to patients with stroke, especially during the acute phase when prolonged bed rest in the supine position is common in stroke unit (SU). Recent studies suggest that rostral fluid shifts may worsen OSA severity. This study aimed to compare OSA severity between patients with acute stroke in a SU and outpatients with OSA using in-laboratory polysomnography (iPSG) to gain further insight into this relationship. This cross-sectional study was conducted at Samsung Changwon Hospital between April 2021 and October 2022. Patients with acute stroke and outpatients who underwent iPSG were included. SU patients were screened for OSA symptoms and selected based on modified Mallampati score ≥ 3. SU patients were assessed using iPSG during their hospital stay after bed rest periods. Propensity score matching (PSM) was used to control for confounding variables. Among 530 SU patients, 30 completed iPSG. SU patients exhibited significantly higher supine apnea-hypopnea index (AHI) than outpatients (60.1 vs 28.4, P = .004). The stroke group showed increased odds of elevated supine AHI (OR = 4.99, 95% CI: 1.90-13.11, P = .001). After PSM adjustment, the association remained significant (OR = 18.47, 95% CI: 1.53-222.20, P = .022). Eighty percent of SU patients had moderate-to-severe OSA (AHI ≥ 15) compared to 60% of outpatients. Patients with acute stroke in a SU demonstrate significantly higher supine AHI compared to outpatients with OSA. These findings suggest that prolonged bed rest and supine positioning during acute stroke management may contribute to OSA severity.

Super refractory status epilepticus (SRSE) is a condition in which status epilepticus persists despite 48 hours of anesthetic treatment. Nonconvulsive status epilepticus (NCSE) is characterized by seizures lasting more than 30 min on an electroencephalogram, with accompanying changes in behavior or consciousness without convulsions. Prompt treatment of NCSE is crucial, as delayed treatment may lead to additional brain damage and progression to convulsive status epilepticus. Although vagus nerve stimulation (VNS) has been approved as an adjunct treatment for drug-resistant epilepsy, it is rarely used to treat refractory status epilepticus. To the best of our knowledge, only two cases of NCSE treated with VNS have been reported to date, and these patients were successfully treated with VNS for NCSE caused by anti-NMDAR encephalitis. We report the case of a patient with posttraumatic epilepsy who developed super refractory-NCSE after convulsive status epilepticus and was successfully treated with VNS.

Abstract Introduction Previous studies suggested that obstructive sleep apnea (OSA) can affect the autonomic nervous system. Patients with OSA appear to have a higher sympathetic component, a lower parasympathetic component, and greater autonomic nervous system (ANS) imbalance. We compared heart rate variability (HRV) with existing studies and confirmed classification accuracy through deep learning analysis (DLA), using electrocardiogram (ECG) data extracted from polysomnography (PSG). Methods We retrospectively surveyed people who underwent PSG at our hospital from January 2015 to March 2023. The diagnosis of OSA was classified into normal, mild, moderate, and severe based on AHI, and whether arrhythmia was identified during the test was also investigated. HRV analysis performed by frequency domain analysis of the tachogram. For DLA, the tachogram was converted to a Mel-spectrogram and a Convolutional Neuronal Network (CNN) was used to confirm the confusion matrix. Results Of a total of 1,806 PSG, 1,554 cases were selected, excluding 252 cases of arrhythmia. OSA confirmed by PSG was normal in 282 patients, mild in 334, moderate in 293, and severe in 645. When comparing the results of HRV divided into AHI below 15 and above, VLF power (ms2/Hz) was 940.78 ± 763.72 vs 1132.75 ± 1104.50 (p < 0.001), LF power (ms2/Hz) was 719.26 ± 734.71 vs. 724.46 ± 945.26 (p = 0.908), HF power (ms2/Hz) was 763.61 ± 1058.92 vs 595.53 ± 1386.75 (p = 0.011), and LF/HF ratio was 1.27 ± 0.74 vs 1.63 ± 1.02 (p < 0.001). As a result of DLA, the ROC AUC Score was confirmed to be 0.7077 and the F1 Score was 0.67. Conclusion As a result of HRV using ECG from PSG, OSA patients were found to have low HF power and high LF/HF ratio, similar to previous studies. Additionally, if tachogram's DLA accuracy can be improved through preprocessing and deep learning model improvements, it is expected that it can be used as a screening tool in various place. Support (if any) This work was partly supported by Institute of Information & Communications Technology Planning & Evaluation grant funded by the Korea government No.RS_2023_00227552, Development of artificial intelligence video background removal SaaS service using domestic semiconductor 64 TOPS.

Background and Purpose People living with epilepsy (PLWE) may wish to discontinue antiseizure medications (ASMs) after long-term remission. However, fear of relapse may lead to continued ASM use. Previous studies have focused on seizure relapse in PLWE who discontinued ASMs after long-term seizure remission (PLWE off ASM), with limited data on those who continued ASMs (PLWE on ASM). Methods We conducted a systematic review and meta-analysis of studies from five databases. We included studies with adult PLWE on ASM with long-term follow-up, using a common-effect model for analysis. Results Seven datasets from six studies were reviewed. Three of the six studies appeared to include some children and adolescents. Significant differences in seizure recurrence proportions (SRP) were found between PLWE whose seizures were controlled on one ASM (PLWE on one ASM) and those whose seizures were controlled on multiple ASMs (PLWE on multiple ASMs) over one to five years of follow-up. After two years, the SRP was 0.1416 for PLWE on one ASM and 0.2479 for PLWE on multiple ASMs. The relative risk (RR) of seizure recurrence for PLWE off ASM compared to PLWE on ASM was 1.9912 after two years, with the RR decreasing over time. Discussion Among PLWE on ASM, PLWE on one ASM have a higher chance of seizure recurrence than PLWE on multiple ASMs. PLWE off ASM have twice the risk of recurrence compared to PLWE on ASM after two years. This information aids PLWE in making informed decisions about ASM continuation or discontinuation.

Objectives: We aimed to investigate public perception of medical specialties in South Korea that diagnose and treat different sleep disorders.Methods: We conducted a web-based survey between January and February 2022, as part of the National Sleep Survey of South Korea 2022. A questionnaire was administered to a stratified, multistage sample of 4,000 random individuals aged 20–69 years from the general population. Participants were asked to select all sleep disorders they believed required treatment from a list. Subsequently, they were asked to identify the clinical department they would visit for each disorder.Results: Sleep apnea (83.4%) and snoring (82.4%) were widely perceived as sleep disorders requiring treatment, followed by insomnia (76.1%), sleepwalking (72.0%), narcolepsy (52.4%), bruxism (49.6%), rapid eye movement sleep behavior disorder (43.4%), excessive daytime sleepiness (33.4%), restless legs syndrome (30.1%), and sleep talking (18.5%). Regarding departments, otorhinolaryngology was the preferred specialty for snoring (79.7%) and sleep apnea (49.4%). More than half of the respondents (55.2%) indicated that they would consult psychiatry department, followed by neurology department (28.2%) for insomnia. Neurology department is preferred for restless legs syndrome, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, and narcolepsy. “Unsure” was a common response for more than 10% of the disorders, excluding snoring and insomnia, highlighting the gaps in public awareness regarding sleep disorders.Conclusions: Public perceptions of the appropriate medical specialties for different sleep disorders vary and are often inconsistent with medical guidelines. Public education regarding the roles of different specialties in managing sleep disorders may improve care by guiding patients to the appropriate specialties.

Purpose Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by REM sleep without atonia (RWA) and is regarded as the prodromal stage of α-synucleinopathies, such as Parkinson’s disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). RWA is also associated with neurodegeneration driven by α-synucleinopathy. However, the level of RWA across the α-synucleinopathy spectrum remains elusive. We aimed to rate the percentage of RWA across the α-synucleinopathy spectrum, encompassing prodromal and overt phenotypes. Methods A systematic search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases. We included cohort, cross-sectional, and case–control studies comparing the RWA percentage during REM sleep evaluated by tonic chin activity (RWA%-T) or by phasic chin activity (RWA%-P) across the α-synucleinopathy spectrum. Bayesian network meta-analysis was used to combine both direct and indirect evidence regarding the group differences in the RWA%-T and RWA%-P. The surface under the cumulative ranking curve was used to estimate the ranked probability. Results Fifteen articles met the inclusion criteria. The investigations included 204 iRBD, 295 PD with RBD (PDwtRBD), 187 PD without RBD (PDwoRBD), 42 MSAwtRBD, 9 DLBwtRBD patients, and 246 controls. MSAwtRBD ranked first in RWA%-T, whereas iRBD ranked first in RWA%-P. RWA% in PDwoRBD patients was comparable to that in the controls and was lower than that in PDwtRBD patients. Conclusion Overt phenotypes such as MSAwtRBD and PDwtRBD ranked high in RWA%-T, whereas iRBD, a prodromal type, ranked highest in RWA%-P. Taken together, our data suggest that the percentage of neurodegeneration in RBD patients may be associated with RWA%-T rather than RWA%-P. Prospero Registration Number CRD42021276445.

Purpose: Numerous inventories to identify felt stigma (FS) in people living with epilepsy (PLWE) have been developed. Past studies have mainly focused on the relationship between FS scores and clinical factors, making it challenging to delineate FS proportions and compare FS between groups. We aimed to integrate FS proportions in PLWE and compare them by continent.Methods: We searched MEDLINE, EMBASE, the Cochrane Library, Web of Science, and Scopus. Among the identified studies, we chose the ones providing an FS proportion measured by Jacoby's Stigma Scale (JSS) and its revised version (JSS-R) in PLWE. We applied the random-effects model.Results: A total of 63 datasets from 47 studies were included. There were 29,924 PLWE, with 14,323 of them experiencing FS. The overall FS proportion was 48.4%. Of these datasets, 51 used JSS, and 12 used JSS-R. The FS proportions were 44.9% for the former and 62.1% for the latter, with significant heterogeneity. In the intercontinental comparison with 51 datasets employing JSS, the difference in FS proportions was insignificant: 51.2% in Africa, 47.2% in Europe, 35.4% in Asia, and 28.8% in the Middle East. Furthermore, the meta regression revealed that the year of each primary study did not influence the FS proportion.Conclusion: Among PLWE, FS proportions depended on the choice of a measurement tool. When measured using JSS, the FS proportion was 44.9%, while it was 62.1% when evaluated with JSS-R. Even though the FS proportions were integrated differently, no substantial differences were observed between continents.

Background Eslicarbazepine acetate (ESL) is a third-generation anti-seizure drug used in patients with focal-onset seizures. This retrospective study aimed to evaluate the efficacy and safety of ESL for the treatment of epilepsy in a real-world clinical setting. Methods From March 2022 to April 2023, the medical records of patients with epilepsy who were prescribed ESL at Gyeongsang National University Changwon Hospital were analyzed. Efficacy outcomes were assessed based on seizure frequency, while safety outcomes included the occurrence of adverse events. Results In total, 93 patients were included in the analysis. Over the 1-year follow-up period, ESL demonstrated a significant reduction in seizure frequency. Seventy patients (75.3%) achieved seizure freedom (including 19 patients who were seizure-free for more than 1 year before taking ESL) and 78 patients (86.7%) experienced seizure reduction. Adverse events were reported in 16 patients (17.2%), with the most commonly observed being hyponatremia (5.4%), dizziness (4.3%), seizure aggravation (3.2%), and somnolence (2.2%). Conclusions In this real-world setting, ESL demonstrated sustained efficacy in reducing seizure frequency over 1 year of treatment. The overall safety profile was acceptable. Hyponatremia occurred at a higher frequency than previously known but improved after the discontinuation or reduction of the drug. These findings support the use of ESL as an effective and well-tolerated option for long-term epilepsy treatment in real-world clinical practice. Key words: Anticonvulsants; Treatment outcome; Safety; Epilepsy.

Rapid eye movement (REM) sleep behavior disorder (RBD) is diagnosed based on a history of dream-enactment behavior and documentation of REM sleep without atonia (RWA) on polysomnography (PSG). RWA can be quantified using various methods. To establish comprehensive and clear PSG criteria for diagnosing RBD, the International RBD Study Group (IRBDSG) has recently published guidelines, which include the use of a video-PSG technical setup, REM sleep staging, RWA scoring, video and audio recording and analyses, and a video-PSG procedure for the diagnosis and identification of the prodromal stages of neurodegenerative diseases. Although the guidelines can identify patients with homogeneous RBD, their applicability in a real-world setting, particularly in Korea, presents challenges. Therefore, the aim of the present study was to evaluate and introduce IRBDSG guidelines and results of Korean sleep experts’ opinion survey for diagnosing RBD based on PSG findings.

Abstract Introduction To our knowledge, there have been studies actively looking for patients with suspected SA in the Stroke Unit (SU), but most of them were conducted using a portable polysomnography (PSG), and no study has performed Level 1 PSG (L1PSG) to date. We conducted L1PSG to the acute stroke patients selected in the SU, and conducted L1PSG to patients who visited the Neurology Outpatient Clinic (NOC) with subjective SA symptoms at the same time. By comparison, we tried to find out the SA characteristics of acute stroke patients. Methods This study was conducted on patients admitted to SU from April 1, 2021 to October 31, 2022, and patients who visited NOC during the same period and underwent L1PSG. Among patients admitted to the SU, trained night shift nurses selected patients with SA symptoms with a modified mallampati score of 3 or higher. Cases under intracranial pressure control or other interventions were excluded. Outpatients were enrolled in patients who underwent L1PSG by visiting the NOC to examine only SA. The results of the pre-sleep questionnaire and L1PSG were compared. Results Of a total of 829 stroke patients admitted to SU, 31 SU patients received L1PSG, and during the same period, 74 patients received L1PSG for SA testing at NOC. The average age of SU and NOC was 56 and 57 years, and the median BMI was 26.9 and 26.4. In the survey, the ISI (7 vs 12, p=0.04) and PSQI (5 vs 7, p=0.021) scores were statistically significantly higher in NOC patients. As a result of the L1PSG, AHI (38.8 vs 23.1, p=0.027), AHI in Supine (59.3 vs 25.6, p=0.004) and NonREM AHI (36.3 vs 20.9, p=0.027) were statistically significantly higher in SU patients. Conclusion Patients screened SA at SU overlooked their symptom and thought their sleep quality was better than that of NOC patients, but the actual AHI was higher. In particular, acute stroke patients show a large difference in AHI in supine compared to NOC, so lateral position can be recommended when absolute bed rest is needed in situations where SA is suspected in SU. More follow-up studies will be needed. Support (if any)