Here , the role of obstructive sleep apnea (OSA)  in overall outcome of ruptured intracranial aneurysms (RIAs) has been investigated.

Data of 159 consecutive patients were retrospectively reviewed. In this series, we have performed Chi square test to determine the significant difference between two groups. Regression analysis was conducted to identify the predictors of unfavorable outcome of ruptured intracranial aneurysms. A p value of <0.05 was considered significant.

The prevalence of OSA in RIAs was five times higher in patients with non-aneurysm group, p=0.002. The number of patients with hypertension (p<0.0001), BMI ≥ 30 (p<0.0001), hyperlipidemia (p=0.018), chronic heart disease (CHD, p=0.002) or prior ischemic stroke (p=0.001) was significantly higher in the OSA group. Similarly, the number of wide neck aneurysms (p<0.0001) and aneurysm with >7mm (p=0.004), poor Hunt and Hess grade IV-V (p=0.005), vasospasms, (p=0.03), patients with poor modified Rankin scale (mRS) scores (3-6) was significantly higher in the OSA group (p<0.0001). Interestingly, for the first time in univariate (p=0.01) and multivariate (p=0.003) regression analysis, OSA was identified as an individual predictor of unfavorable outcome of RIAs. In addition, hypertension (p=0.04), smoking (p=0.049), chronic heart disease (0.01), Hunt and Hess grade IV-V (p=0.04), were revealed as predictors of poor outcome of RIAs.