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Stroke during sleep and obstructive sleep apnea: there is a link
Yousef Mohammad1, Ahmed Almutlaq2, Abdullah Al-Ruwaita2
1Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia. ymohammad@ksu.edu.sa.
Summary
Obstructive sleep apnea (OSA) is significantly more common in patients who experience wake-up strokes (WUS). This suggests OSA is a key risk factor for strokes occurring during sleep, necessitating clinical vigilance.
Area of Science:
- Neurology
- Sleep Medicine
- Cardiovascular Research
Background:
- Ischemic stroke symptoms exhibit diurnal variation, with a notable percentage occurring during sleep.
- Obstructive sleep apnea (OSA) is a recognized risk factor for ischemic stroke.
- Limited data exists on the association between OSA and wake-up stroke (WUS).
Purpose of the Study:
- To investigate the relationship between obstructive sleep apnea (OSA) and wake-up stroke (WUS).
Main Methods:
- A case-control study was conducted on acute stroke patients at two major medical centers in Riyadh, Saudi Arabia.
- Patients were categorized as WUS (stroke symptoms upon waking) or non-wake-up stroke (NWUS; stroke occurred while awake).
- The Berlin Questionnaire assessed OSA frequency in both WUS and NWUS groups.
Main Results:
- Of 107 acute stroke patients, 40 had WUS and 67 had NWUS.
- Obstructive sleep apnea (OSA) was diagnosed in 72.5% of WUS patients versus 45% of NWUS patients.
- Logistic regression revealed OSA is highly prevalent in WUS patients (OR = 3.25, p = 0.0053).
Conclusions:
- Obstructive sleep apnea (OSA) is an important risk factor for ischemic stroke occurring during sleep.
- Healthcare providers should screen all ischemic stroke patients for OSA symptoms, particularly those with WUS.
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