Cerebral Microbleeds on MRI in Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is known to increase the risk of stroke. Cerebral microbleeds (CMBs) are considered one of the precursors to symptomatic stroke. We aimed to clarify the relationship between OSA and CMBs.

We recruited patients who visited our clinic for the evaluation of sleep-disordered breathing. All patients underwent both overnight polysomnography and brain magnetic resonance imaging, which included T2*-weighted gradient-recalled echo images. We applied multivariate logistic regression and partial correlation analysis to estimate the relationship between OSA and CMBs.

A total of 75 (45 male, 30 female) patients were enrolled. Their mean age was 60.5 years. Patients with CMBs had a significantly higher apneahypopnea index (AHI) compared with those without CMBs. AHI equal to or greater than 15 was a significant independent predictor of CMBs (adjusted odds ratio, 4.51; 95% CI, 1.40-14.58; p = 0.012) in the multivariate regression analysis. In addition, a partial correlation analysis adjusted for age, hypertension, diabetes, and cardiovascular disease revealed a positive relationship between AHI and the number of CMBs (r = 0.585, p = 0.028).

Moderate-to-severe OSA can be one of the independent predictors of CMBs which are considered a surrogate marker of overt stroke.