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Sleep apnea and stroke
1Department of Neurology, Upstate Medical University, Syracuse, NY, USA.
Abstract:
The concept of sleep apnea as a risk factor for primary stroke derives mainly from evidence implicating sleep-disordered breathing (SDB) in the causation or aggravation of systemic hypertension and heart disease. Evidence of an association between SDB and sustained systemic hypertension is available from several large studies, though the exact mechanism involved is unknown. Another study found a 37% increase in risk of developing cardiovascular disease among middle-aged men attending a sleep clinic. The same study also found that treatment of SDB reduced the cardiovascular risk. Other mechanisms less well studied linking SDB with cerebrovascular risk include reduction in cerebral blood flow, altered cerebral autoregulation, impaired endothelial function, and accelerated proinflammatory states.
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