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Obstructive sleep apnea as a risk factor for stroke and death.
H Klar Yaggi1, John Concato, Walter N Kernan
1Section of Pulmonary and Critical Care Medicine, Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, Conn 06520, USA.
The New England Journal of Medicine
|November 12, 2005
Summary
Obstructive sleep apnea syndrome significantly increases the risk of stroke or death. This association remains independent of other major risk factors like hypertension, highlighting its importance in cardiovascular health.
Area of Science:
- Cardiology
- Neurology
- Sleep Medicine
Background:
- Obstructive sleep apnea syndrome (OSAS) is a potential risk factor for stroke.
- Independent association of OSAS with stroke or all-cause mortality, adjusted for confounders, remains unclear.
Purpose of the Study:
- To determine if OSAS is an independent risk factor for stroke or death.
- To assess the impact of OSAS on the composite outcome of stroke or all-cause mortality.
Main Methods:
- Observational cohort study of 1022 patients undergoing polysomnography.
- OSAS diagnosed with an apnea-hypopnea index (AHI) ≥ 5; comparison group had AHI < 5.
- Proportional-hazards analysis used to evaluate independent effects of OSAS.
Main Results:
- 68% of patients had OSAS (mean AHI=35 vs. 2 in controls).
- OSAS associated with increased risk of stroke or death (unadjusted HR=2.24, P=0.004).
- Adjusted analysis confirmed significant association (HR=1.97, P=0.01), independent of hypertension and other factors. Increased apnea severity correlated with higher risk (P=0.005).
Conclusions:
- OSAS is an independent risk factor for stroke or death.
- The increased risk associated with OSAS is significant even after accounting for hypertension and other comorbidities.