People with sleep apnea at
higher risk of stroke
People with sleep-related breathing
disorders, such as habitual snoring and sleep apnea, are at higher risk of suffering a
stroke, according to a study by Yale researcher published in the June issues of the
journal Stroke.
"Sleep-related breathing disorders
are strongly associated with increased risk of stroke independent of know risk
factors," said Vahid Mohsenin, M.D., director of the Yale Center for Sleep Disorders
and principal investigator of the study. "Since sleep-related breathing
disorders are treatable, patients with stroke and transient ischemic attacks should be
investigated for these conditions."
Stroke, according to the American Heart
Association, is the third leading cause of death in the United States after coronary
disease and cancer. There are about 600,000 cases of stroke each year and 150,000 are
fatal.
Mohsenin said there have been recent
studies showing a strong association between stroke and sleep-related breathing
disorders. His study suggests that sleep-related breathing disorders are modifiable
risk factors for stroke.
"The mechanics underlying this
increased risk of stroke are multifactorial and include reduction in cerebral blood flow,
altered cerebral autoregulation, and increased platelet aggregation and plasma fibrinogen
level". he said.
The most common presentation of sleep
apnea disorder is excessive daytime sleepiness and unrefreshing sleep, he said, adding
that many people describe falling asleep during inappropriate occasions.
Intermittent snoring with breath holding
terminated by loud snorts and body movements is a typical feature that patients may not be
able to report about themselves," Mohsenin said.
"A detailed history from a bed partner, when there is one, is of crucial
importance."
Other related complaints include restless
sleep, chocking or coughing during sleep, excessive urination at night, and
headaches. Physical examination of the upper airways may disclose, among other
conditions, a deviated nasal septum, an enlarged tongue, a redundant soft palate, or
paralysed vocal cords.
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