Association of Sleep-disordered Breathing and the Occurrence of Stroke

Abstract

These data demonstrate a strong association between moderate to severe sleep-disordered breathing and prevalent stroke, independent of confounding factors. They also provide the first prospective evidence that sleep-disordered breathing precedes stroke and may contribute to the development of stroke.

Sleep Apnea and Cardiovascular Disease

“…However, in the prospective longitudinal analysis of these data, after adjustment for age, sex, and BMI, the OR was still elevated but no longer statistically significant (OR, 3.08; 95% CI, 0.74 to 12.81; Pϭ0.12). 212 Recent 10-year follow-up data of patients with stroke show an increased risk of death in those patients with OSA (adjusted hazard ratio, 1.76; 95% CI: 1.05 to 2.95; Pϭ0.03) that is independent of age, sex, BMI, smoking, hypertension, diabetes mellitus, atrial fibrillation, Mini-Mental State Examination Score, and Barthel Index of Activities of Daily Living. In contrast, CSA was not accompanied by increased poststroke mortality compared with control subjects (adjusted hazard ratio, 1.07; 95% CI: 0.65 to 1.76; Pϭ0.80).…”

Association of sleep apnea with clinically silent microvascular brain tissue changes in acute cerebral ischemia

“…Stroke clinicians have recognized sleep apnea as an independent risk factor for clinically apparent ischemic strokes [22][23][24]. It is unclear, however, whether sleep apnea contributes to the development of chronic microvascular brain tissue changes.…”

“…The collection of both TIA and acute stroke patients may have added another bias to our results. However, larger observational studies suggest that sleep apnea precedes acute stroke events (establishing it as a risk factor as opposed to a clinical manifestation of acute brain damage) and only a minority of patients experience relevant improvement of their sleep pattern over time [22,23,35]. Second, patients with gait and urinary incontinence were not excluded diminishing the validity whether the radiological classified chronic microvascular brain tissue changes were ultimately "silent".…”

CPAP ohne Effekt auf kardiovaskuläres Risiko

“…"Sleep Heart Health Study" oder die "Wisconsin Sleep Cohort Study" zeigten, dass die obstruktive Schlafapnoe (OSA) das kardio-und zerebrovaskuläre Risiko erhöht [1,2,3,4,5]. Zwei nicht randomisierte Studien mit zusammen 2.767 Patienten [4,5] …”