Cerebrovascular Correlates of Sleep Disorders-Rational and Protocol of a Door-to-Door Survey in Rural Coastal Ecuador

Background: Little is known on the role of sleep disorders in the increased prevalence of cerebrovascular diseases in the developing world. Aims: The aim of this study is to assess the prevalence of major sleep disorders in a rural South American population and to determine whether these conditions are associated with stroke, ischemic heart disease, or with a poor cardiovascular health (CVH). Design: Three-phase, population-based, door-to-door survey in Atahualpa. During phase I, all residents aged 40 years or older will be screened with validated Spanish versions of 5 questionnaires to evaluate major sleep disorders. In phase II, neurologists will examine persons suspected of having a sleep disorder and a random sample of negative individuals to assess the prevalence of these conditions and to validate the accuracy of questionnaires. In phase III, patients with a confirmed sleep disorder will undergo nocturnal polysomnography for achieving a more specific diagnosis. The occurrence of sleep disorders will be correlated with the CVH of the population and with the presence of stroke and ischemic heart disease. Discussion: This epidemiologic study may prove cost-effective in improving sleep conditions of people living in rural areas of developing countries and may be used as a model for the evaluation of sleep disorders and their cerebrovascular correlates in these populations.