Occurrence of Obstructive Sleep Apnea Syndrome in Patients with Transient Ischemic Attack

Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder with episodes of upper airway obstructions. Patients with cardiovascular diseases such as myocardial infarction and stroke show a high prevalence of OSAS. Several studies focus on stroke and not on transient ischemic attack (TIA), suggesting it could be a symptom after stroke. We analyzed the occurrence of OSAS in high-risk patients with TIA.

There were 555 patients suspected for TIA by the general practitioner who were referred to our TIA daycare clinic. They were screened for OSAS using 3 screening factors: snoring (yes/no), body mass index greater than or equal to 30, and Epworth Sleepiness Score greater than 10. When 2 out of 3 were positive, patients received a polysomnography. An apnea-hypopnea index (AHI) of 5-15 is defined as mild OSAS, AHI 15-30 as moderate OSAS, and AHI greater than 30 as severe OSAS.

Seventy-seven patients received a polysomnography. Twenty-five patients had a diagnosis of TIA and 18 had a diagnosis of cerebral ischemia, whereas 34 had other diagnoses. Twenty of the 25 (80%) TIA patients had OSAS, compared to 16 of the 34 (47%) patients without a vascular diagnosis (P = .010). When excluding patients with a cardiovascular history, we found 15 of the 20 patients with OSAS, compared to 14 out of 30 patients (P = .047).

There is a significant higher occurrence of OSAS in TIA patients compared to patients without a vascular diagnosis, even after excluding patients with a history of cardiovascular events.