Related Experiment Video
Updated: Dec 29, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Impact of obstructive sleep apnea on silent cerebral small vessel disease: a systematic review and meta-analysis
Anthipa Chokesuwattanaskul1, Ploypin Lertjitbanjong2, Charat Thongprayoon3
1Division of Neurology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand; King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Insights
Obstructive sleep apnea (OSA) is linked to cerebral small vessel disease (CSVD) markers like white matter hyperintensity and lacunar infarction. This association highlights OSA as a potential contributor to vascular dementia risk in aging populations.
Area of Science:
- Neurology
- Cardiology
- Sleep Medicine
Background:
- Cerebral small vessel disease (CSVD) is a major cause of vascular dementia in the elderly.
- Obstructive sleep apnea (OSA) is a known cardiovascular risk factor.
- The direct relationship between OSA and CSVD requires further elucidation.
Purpose of the Study:
- To investigate the association between obstructive sleep apnea (OSA) and cerebral small vessel disease (CSVD).
Main Methods:
- A systematic review and meta-analysis of 14 observational studies.
- Included 4335 patients comparing those with and without OSA.
- Utilized random-effect, generic inverse variance method for effect estimation.
Main Results:
- Patients with OSA showed a significant association with white matter hyperintensity (WMH) (OR 2.31) and asymptomatic lacunar infarction (ALI) (OR 1.78).
- No significant association was found between OSA and cerebral microbleeds (CMBs) (OR 2.15).
- High heterogeneity (I² values) was noted in WMH and CMBs findings.
Conclusions:
- OSA is associated with specific CSVD markers, including WMH and ALI.
- The lack of association with CMBs may stem from imaging sensitivity or differing disease mechanisms.
- Findings suggest OSA may contribute to the development of CSVD.
Background:
Cerebral small vessel disease (CSVD) is a well-known cause of vascular dementia, a leading medical morbidity in the aging population. Obstructive sleep apnea (OSA) has been validated as a cardiovascular risk factor. However, the relationship between these two clinical syndromes is not well established. We aimed to assess the association between OSA and CSVD.
Methods:
Databases were searched from inception through May 2019. Studies that reported incidence or odd ratios of CSVD in patients with OSA were included. Effect estimates from the individual studies were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird.
Results:
A total of 14 observational studies comprising of 4335 patients were included into the analysis. Compared to patients without OSA, patients with OSA were significantly associated with CSVD magnetic resonance imaging (MRI) findings of white matter hyperintensity (WMH) and asymptomatic lacunar infarction (ALI) with a pooled OR of 2.31 (95% confidence interval [CI], 1.46-3.66, I2 = 79%) and 1.78 (95% CI, 1.06-3.01, I2 = 41%), respectively. However, there was no significant association between OSA and findings of cerebral microbleeds (CMBs), with a pooled odds ratio (OR) of 2.15 (95% CI, 0.64-7.29, I2 = 55%).
Conclusions:
Our study demonstrated the association between OSA and CSVD MRI findings of white matter hyperintensity (WMH) and asymptomatic lacunar infarction (ALI) when compared to patients without OSA. The absence of an association of CMBs findings with OSA could be due either by a lower sensitivity of neuroimaging techniques utilized to detect CMBs or a potentially different pathogenesis of CMBs.
More Related Videos
07:54Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
12:15Optimized System for Cerebral Perfusion Monitoring in the Rat Stroke Model of Intraluminal Middle Cerebral Artery Occlusion
Published on: February 17, 2013
