Diagnosis and Treatment of Sleep Apnea Crucial to Stroke Prevention
In early October, the Canadian Stroke Congress updated their stroke care guidelines to state that proper diagnosis and screening of sleep apnea is critical to stroke prevention.
The Canadian Best Practice Recommendations for Stroke Care was first released in 2006. This is the fourth update to the guidelines, and the first time the best practice guidelines have included a section on obstructive sleep apnea (OSA).
OSA is a breathing disorder that causes a person’s breathing during sleep to be paused and/or shallow. The pauses generally last 10 to 20 seconds, and in severe cases, can occur hundreds of times a night. With OSA, the airway is blocked and/or collapses while sleeping. Air squeezing by the blockage can cause loud snoring and interrupted sleep.
As a result of the paused breathing and/or snoring, many sleep apnea sufferers are woken up throughout the night and spend more time in light sleep, rather than deep, restful REM (rapid eye movement) sleep. This chronic sleep deprivation results in daytime sleepiness, and can negatively affect job performance, mood, reflexes and concentration. Over time, untreated OSA can lead to cardiovascular health problems, such as weight gain, diabetes, high blood pressure, heart disease, and stroke.
A February press release by the American Heart Association, shared the results of a German study which linked sleep apnea with an increased risk of silent strokes and small lesions in the brain.
The study was conducted by Jessica Kepplinger, M.D., stroke fellow in the Dresden University Stroke Center’s Department of Neurology at the University of Technology in Dresden, Germany. The results were presented at the American Stroke Association’s International Stroke Conference 2012.
Dr. Kepplinger and researchers found a surprisingly high frequency — 91 percent of the patients studied who had a stroke also had sleep apnea. The patients with severe OSA were more likely to have silent strokes, and the severity of the sleep apnea increased the risk of being disabled when a patient was discharged from the hospital.
This and other research emphasizes the importance of recognizing sleep apnea as a stroke risk factor, and the new Canadian Stroke Congress recommendations call for more screening of stroke patients who report tiredness, snoring, or fragmented sleep. Dr. Michael Hill, Canadian Stroke Congress Co-Chair, says that stroke care is not only about giving the best possible treatment to patients, but also about preventing new and recurrent strokes.
Read the study, “Sleep apnea plays dual role in stroke.”
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