Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jun;3(3):192-201.
doi: 10.1212/CPJ.0b013e318296f274.

Early diagnosis and treatment of obstructive sleep apnea after stroke: Are we neglecting a modifiable stroke risk factor?

Arielle P Davis  1 , Martha E Billings, W T Longstreth Jr, Sandeep P Khot
Affiliations

Early diagnosis and treatment of obstructive sleep apnea after stroke: Are we neglecting a modifiable stroke risk factor?

Arielle P Davis et al. Neurol Clin Pract. 2013 Jun.

Abstract

Sleep-disordered breathing is an increasingly recognized disorder that is particularly prevalent among stroke patients. Obstructive sleep apnea, a form of sleep-disordered breathing, is associated with multiple major stroke risk factors but is also an independent risk factor for stroke. In addition, untreated sleep apnea is associated with poor functional outcome after stroke. Sleep apnea is amenable to treatment and should be considered a modifiable stroke risk factor, though long-term compliance remains a major barrier. A better understanding of the relationship between sleep apnea and stroke may prompt providers to pursue the early diagnosis and treatment of underlying sleep-disordered breathing to both improve the chance of recovery from stroke in the short term and to reduce the risk of recurrent stroke in the long term.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Imaging in case 1
(A) Diffusion-weighted MRI demonstrates a right cerebellar infarct and (B) pontine infarcts. (C) Catheter angiogram with a left vertebral injection reveals poor flow and multifocal narrowing of the basilar artery (black arrows).
Figure 2
Figure 2. Physiologic recordings in a patient with obstructive sleep apnea
Simultaneous recordings of arterial oxygen saturation (SaO2), transcutaneous arterial PCO2 (PtcCO2), mean arterial blood pressure (MAP), cerebral blood flow velocity (CBFV), and airflow. Note the fluctuations in MAP and CBFV away from baseline (dashed lines) during and following apnea. With repetitive apneas, as demonstrated here, CBFV remains below baseline for the majority of the recording. (Reprinted with permission of the American Thoracic Society. Copyright© 2012 American Thoracic Society. From: Balfors EM, Franklin KA. Impairment of cerebral perfusion during obstructive sleep apneas. Am J Respir Crit Care Med 1994;150:1587–1591.)e1
See this image and copyright information in PMC

References

    1. Skolarus LE, Lisabeth LD, Morgenstern LB, Burgin W, Brown DL. Sleep apnea risk among Mexican American and non-Hispanic white stroke survivors. Stroke 2012;43:1143–1145 - PMC - PubMed
    1. Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42:227–276 - PubMed
    1. Young T, Palta M, Dempsey J, Peppard PE, Nieto FJ, Hla KM. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study. WMJ 2009;108:246–249 - PMC - PubMed
    1. Hermann DM, Bassetti CL. Sleep-related breathing and sleep-wake disturbances in ischemic stroke. Neurology 2009;73:1313–1322 - PubMed
    1. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342:1378–1384 - PubMed

LinkOut - more resources