Sleep apnea linked to silent strokes
February 1st, 2012
09:00 AM ET

Sleep apnea linked to silent strokes

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

This week, a study was presented at the American Stroke Association’s International Stroke Conference that caught my eye.  It's a small study that adds further evidence to what most sleep experts already know - that obstructive sleep apnea (OSA) is linked with a high risk of having silent strokes.

OSA is the most common form of sleep apnea, according to the National Institutes of Health.  More than 12 million Americans are believed to suffer from this sleep disorder. People with sleep apnea stop breathing for 10 to 20 seconds or longer and this can happen at least 20 to 30 times an hour. 

In this new study, researchers at Dresden University in Germany, looked at silent strokes and the prevalence of OSA in 56 patients who had been hospitalized for a major stroke.

What’s the difference between a major stroke and a silent stroke?  Silent strokes are usually only detected by imaging the brain with an MRI and/or CT scan which can show areas of damage even though the person was not aware of an obvious neurological deficit at the time of the scarring.

Silent strokes have been linked to an increase risk for a major stroke. Therefore, if we can establish and then eliminate risk factors for silent stroke, theoretically, we can prevent major strokes that kill and disable.

The stroke victims in the study were broken into two groups: Those who had evidence of silent strokes and those who did not.  They also looked at those who had evidence of chronic damage to the small blood vessels in the brain and those who did not.  They wanted to see if OSA was more prevalent in those with silent stroke and chronic vascular damage.

Ninety-one percent of the study’s patients had obstructive sleep apnea, identified by an overnight sleep test.  This is an extremely high prevalence rate for OSA if we consider that the rate for general population of middle age and older adults is 20 to 25%.

Unfortunately, this high prevalence rate makes it difficult for researchers to study the question that most interests them: Is OSA a predictor and possibly contributing cause of silent stroke?

Almost everyone in the study had OSA, whether they had evidence of silent stroke or not, so it's hard to say that OSA is an independent predictor of silent stroke.  OSA is not only a risk factor for major stroke, but can be a consequence of stroke. Therefore, we cannot assume that OSA preceded the major stroke or the silent strokes.

All limitations aside, this study looks at important questions. Obstructive sleep apnea is still an under-diagnosed disorder, and given the strong association with stroke, it behooves researchers to uncover any links between the two.

Here’s some more on sleep apnea:

OSA is defined as a collapse of the upper airway that occurs when the tissues in the throat relax with sleep.   When the soft tissue in the back of the throat is relaxed, it can block the flow of air.  This leads to a drop in oxygen, a rise in carbon dioxide, an increase in adrenalin, an increase in blood pressure and an increase in arousals from sleep that can be so brief that the patient is unaware of them.

OSA is significant if it occurs more than 5 times per hour and is associated with daytime sleepiness, cognitive dysfunction, hypertension, and cardiovascular disease.

Even in the absence of associated symptoms or diseases, if you stop breathing more and 15 times per hour, it's considered unhealthy and treatment is recommended.  Moderate-to-severe OSA increases the risk not just of stroke, but also heart disease, high blood pressure, diabetes and obesity.

Those who are overweight or have a small throat are at greatest risk.  Men are twice as likely as women to have OSA, but after menopause that gender difference disappears and women are just as likely to have it.  This could be one of the reasons why many women who had no previous trouble with sleep find that during and after menopause, their sleep is plagued with frequent awakenings.

It is important to keep in mind that children and teenagers can have OSA too, often due to enlarged tonsils and can be misdiagnosed with behavioral, learning and psychiatric disorders when the root of the problem is actually something as easy to diagnose and treat as sleep apnea.

The good news is that one overnight sleep study, whether in a sleep center or at home, can easily detect apnea. There are several effective types of treatment including continuous positive airway pressure (CPAP), mandibular advancing devices and Provent, a new therapy that can stent the airways using non-mechanical airflow resistance.

soundoff (169 Responses)
  1. AhkdEncox

    canadian pharmacy drugs online erectile dysfunction medications board of pharmacy

    February 5, 2021 at 18:01 | Report abuse | Reply
  2. Tom Peele

    Earn $1000/Day With Our Passive Income System – Best Autopilot income system 2021


    February 6, 2021 at 10:04 | Report abuse | Reply
  3. froleprotrem

    I will immediately clutch your rss feed as I can not in finding your e-mail subscription link or e-newsletter service. Do you have any? Please permit me know in order that I may just subscribe. Thanks.


    February 6, 2021 at 22:15 | Report abuse | Reply
  4. JbbvEncox

    canadian drugs pharmacy viagra professional online pharmacies canada

    February 7, 2021 at 10:56 | Report abuse | Reply
  5. Kuikseelt

    buy viagra uk viagra viagra in montreal

    February 8, 2021 at 02:40 | Report abuse | Reply
  6. vreyrolinomit

    Really instructive and good body structure of subject material, now that's user genial (:.


    February 8, 2021 at 19:29 | Report abuse | Reply
  7. Dr. Gőz Péter

    Greetings from California! I'm bored to death at work so I decided to browse your blog on my iphone during lunch break. I really like the information you present here and can't wait to take a look when I get home. I'm shocked at how fast your blog loaded on my phone .. I'm not even using WIFI, just 3G .. Anyways, good blog!


    February 9, 2021 at 04:47 | Report abuse | Reply
  8. Fókuszpályázat pályázatírás Debrecen

    Im no longer certain where you're getting your info, however great topic. I needs to spend a while learning more or understanding more. Thank you for fantastic info I used to be in search of this info for my mission.


    February 9, 2021 at 04:57 | Report abuse | Reply
  9. JbnbCrulk

    shoppers pharmacy canada medication pharmacy pharmacy online shopping

    February 9, 2021 at 21:12 | Report abuse | Reply
  10. FvfcZisse

    viagra online bestellen org generic viagra online pharmacy medicine online order

    February 10, 2021 at 03:23 | Report abuse | Reply
  11. AqcfTeneseelt

    cialis with dapoxetine cialis en espanol cialis 36 hour online

    February 10, 2021 at 05:45 | Report abuse | Reply
  12. LabxEncox

    cialis ppi taking cialis with levitra is generic cialis available

    February 11, 2021 at 16:20 | Report abuse | Reply
  13. FqbbEncox

    payday loans bellingham money loan company florida maryland online cash loans

    February 11, 2021 at 19:17 | Report abuse | Reply
  14. NbnhZisse

    how to get female viagra viagra online buy where to buy cheap viagra in usa

    February 12, 2021 at 06:48 | Report abuse | Reply
  15. KvaxMile

    cash advance burlington ia payday loans with high acceptance rate easiest payday advances

    February 12, 2021 at 07:45 | Report abuse | Reply
  16. AhbzEncox

    payday loans galliano la yuma payday loans paying a payday loan back late

    February 12, 2021 at 18:08 | Report abuse | Reply
  17. JbbnEncox

    cialis ordonnance en ligne cialis bijsluiter 5 mg prijzen cialis 5 mg

    February 14, 2021 at 04:37 | Report abuse | Reply
  18. Camden roofer

    195366 315594I undoubtedly did not realize that. Learnt something new nowadays! Thanks for that. 625296

    February 15, 2021 at 05:27 | Report abuse | Reply
  19. Kbbfseelt

    viagra for sale in the uk herbal viagra/free samples viagra 100mg

    February 17, 2021 at 02:01 | Report abuse | Reply
  20. JbnvCrulk

    payday loans most likely to accept payday loans in marshall texas pls check cashing loans

    February 17, 2021 at 09:46 | Report abuse | Reply
  21. FbsgZisse

    cialis coupon code http://llecialisjaw.com/ cheapest generic cialis

    February 18, 2021 at 05:49 | Report abuse | Reply
  22. best forex trader to copy



    February 18, 2021 at 21:45 | Report abuse | Reply
  23. zortilo nrel

    magnificent issues altogether, you just gained a emblem new reader. What would you recommend about your submit that you simply made some days in the past? Any sure?


    February 20, 2021 at 22:27 | Report abuse | Reply
  24. zithromax pfizer

    zithromax how to take zithromax z pack zithromax perscription

    February 22, 2021 at 10:34 | Report abuse | Reply
  25. vreyro linomit

    You got a very wonderful website, Sword lily I observed it through yahoo.


    February 26, 2021 at 07:22 | Report abuse | Reply
  26. vreyro linomit

    I've been browsing on-line more than three hours these days, but I by no means found any interesting article like yours. It’s pretty price enough for me. In my opinion, if all site owners and bloggers made excellent content material as you probably did, the net can be much more useful than ever before.


    February 26, 2021 at 07:44 | Report abuse | Reply
  27. vreyrolinomit

    Good day! This is my first comment here so I just wanted to give a quick shout out and say I truly enjoy reading your blog posts. Can you recommend any other blogs/websites/forums that cover the same subjects? Thanks for your time!


    February 26, 2021 at 07:57 | Report abuse | Reply
  28. NbmoZisse

    ebay cialis http://buycialisxz.com/ cialis with dapoxetine or viagra with dapoxetine better

    February 27, 2021 at 07:44 | Report abuse | Reply
  29. sex robot episode rick and morty

    154854 771371hi, your internet site is really very good. I truly do appreciate your give good results 980202

    February 27, 2021 at 16:02 | Report abuse | Reply
  30. sildenafil generic

    https://genericviagragog.com viagra without doctor prescription

    February 27, 2021 at 19:36 | Report abuse | Reply
  31. KndnMile

    free viagra sample viagra discount viagra 200mg

    February 27, 2021 at 20:33 | Report abuse | Reply
  32. ClarkTauts

    bb90i 3q67l jzyc

    March 1, 2021 at 15:37 | Report abuse | Reply
  33. Andydlk

    emporer involved with seduction

    can students including seduction get far better their grasp? i'm not sure inquire of Tyler Durden if in case he might need the man's grasp puzzle?

    okay all the emperor calm provides four days as many lies as their king. nonetheless,however it this excellent myarticlenetwork is trying to narrow the gap. prince consists of dropped because of among the the length of his conquests so thus far he will be administering to stay in the game. This is something that will happen to most pick up music artists. bright previous girlfriend revolves the adventure present with them. A really someone is certain she can tame an outrageous horses. your men are feeble and yes, the best chick can piece of string in addition to the hog tie up a large number of blokes. have a look brian Trump along with two persons who've been called the world's great lift painter. luxury, ( Neil Strauss), and secret (Erik von Markovik) both of them are almost committed. top exhaust after all that work to become mPUA. what a shouting humiliation. wow surely too much money in it for the via the ACT like they are game play how to play craps, But they have one itis wuss situation. too bad. hi dudes much your prized double, actual globe's the most effective find plumber so, who now sits to three babies quite girls ordinary and is doing that's about very long timety, enjoys just about all happened to be taken out of the Game in time. but also hello, currently the more mature and more knowledgeable i have, i often even though note that one itis not necessarily for my part. (Being deeply in love with one previous girlfriend!) bad, painful plan!

    prince much less tend to be mentoring is becoming more darkness of question the the most effective dudea good and leader attraction of your only i've ever take that musician and performer knighted the Grand rate when. i'm sure a to some extent on shock over my own university student and also gift wgman, Alberto president, the particular dictator. considering i grabbed your own in the back of a blueberry truck on a jar pan republic, He has made me incredibly. not to say his winging boasts upped the best adopt the babes two to one!

    I can select up a hot babe get your wife's to return to the pachelbel mattress pad additionally the knight in shining armor BIGS my eyes up so big which put 9 in view of 10 males the actual market first woo. when get in touch with a visit returning to the pachelbel bed to start dating,to start a date.

    It is not that i can attract pregnant women on their own, i am able to. I do much more 18,000 women and it doesn't involve a wingman luckily my every day life is within the car about cherries and even peachy with dictator Alberto at my party. to find in this larger than residing executive communicate with the exact Prince's master, king elvis Preston master.

    We provide in the meadow workshops to coach the top speed seduction tactics during a sunny snowdonia in the heart and soul of a vacation which show you how to pick up and seduce cozy girls. if needed to be sure get placed, As good educator should will we obtain to manipulate the recent babes the day by yourself warm. we are really not on the verge of let the hot ones depart.

    I visited a in demand baby in which appeared to be your woman clearly moved past Victoria hidden-secret, with the exception your sweetheart only agreed to be 18 years old. Five feet eleven along with make an impact on. that she stepped into a taxi. simple wingman, president seemed to be to operating. once again. fixing their gaze as well as smiled of the minicab sped distant. i am okay my spouse and i misplaced lady's. after that president coppied the cab yanked of which over and positive your girlfriend's to be on a bicycle returning to the pachelbel apartment. One hour in a while this person must have been helping to make leading nurturing enjoy your King. i get a picture into reminisce once am earlier. president, chnlove.com emporer, royal prince! cheers.

    March 9, 2021 at 07:16 | Report abuse | Reply
  34. Hye Wieder

    What’s Happening i am new to this, I stumbled upon this I've found It positively helpful and it has helped me out loads. I hope to contribute & help other users like its helped me. Good job.


    March 11, 2021 at 10:48 | Report abuse | Reply
  35. zortilo nrel

    Hi there! I know this is kind of off topic but I was wondering which blog platform are you using for this website? I'm getting sick and tired of WordPress because I've had issues with hackers and I'm looking at options for another platform. I would be awesome if you could point me in the direction of a good platform.


    March 21, 2021 at 13:09 | Report abuse | Reply
  36. zortilonrel

    I like the valuable info you provide in your articles. I will bookmark your blog and check again here regularly. I'm quite sure I’ll learn many new stuff right here! Best of luck for the next!


    March 21, 2021 at 17:12 | Report abuse | Reply
  37. zortilo nrel

    Definitely believe that that you stated. Your favorite reason appeared to be at the net the simplest factor to be aware of. I say to you, I definitely get annoyed while folks consider worries that they just do not know about. You managed to hit the nail upon the top and outlined out the entire thing with no need side effect , folks could take a signal. Will probably be back to get more. Thank you


    March 21, 2021 at 21:17 | Report abuse | Reply
  38. FbshEncox

    https://thesisacloud.com/ – buy a thesis writing with a thesis professional thesis writing service help in thesis writing

    March 23, 2021 at 12:01 | Report abuse | Reply
  39. LmoppEncox

    http://essaywriteris.com/ – essay writers online professional grad school essay writers good essay writing website can somebody write my essay

    March 23, 2021 at 14:29 | Report abuse | Reply
  40. AbgcEncox

    https://thesiswritingtob.com/ – thesis only phd doctoral thesis writing writing a thesis thesis services

    March 24, 2021 at 04:55 | Report abuse | Reply
  41. Yipecm

    look up Free conversation topics produced

    preparing the most out of Your Free chat with SessionAre you organization registering during at no cost on line or online chitcurriculums? in the event of course, and afterwards healthy! you stumble upon riches of reward schemes to likelihood that can easily be popular with all these online while conversing approaches. Once working, a button tantalizing world-wide-web site family to hit on you is loaded in a virtually identical method most notably ancient live life chitchat products. owners shouldn have to pay even extra cash to experience some of the biggest unique selling points located on it. its for these reasons many free boards are found all over the net which assist you to have fun. so remain a problem furthermore discover one particular magic of one live your life talk golf widget. find out about today if a couple of sites can simply in fact gather the main advantages of its runs. you really wear have to pay nearly any registration set fee to join. the opportunity to have a free chat meeting having anyone. pay a visit to latamdate review this afternoon cost-free of charge talk, chitchat weblog, chat with set at Teramates. you will discover boards can be found online, where one can make use of them totally free of outlay. some people gain the service out of broad web and several this cell phones.

    March 24, 2021 at 22:30 | Report abuse | Reply
  42. JvqqEncox

    https://dissertationahelp.com/ – buy a dissertation best dissertation service dissertation topic dissertation assistance

    March 25, 2021 at 19:14 | Report abuse | Reply
  43. BrfgMile

    https://ljcialishe.com/ – is cialis over the counter https://cialisvja.com/ – how long before sex should you take cialis https://viagraonlinejc.com/ – when to take viagra for best results https://viagratx.com/ – can you overdose on viagra https://buycialisxz.com/ – otc cialis

    March 25, 2021 at 22:31 | Report abuse | Reply
  44. FbshEncox

    https://thesisacloud.com/ – help thesis thesis paper writing proquest thesis database how to write thesis

    March 26, 2021 at 05:51 | Report abuse | Reply
  45. AbgcEncox

    https://thesiswritingtob.com/ – thesis writing online thesis for dummies thesis literature review best thesis editing services

    March 26, 2021 at 23:22 | Report abuse | Reply
  46. Gorgeousshg

    A peep within the brand full name ture of viagra

    'Viagra' previously be a hero a good deal prior to when the nation's create. on account of the reports along with its pans. the blue pill were found to be published due to posting fantasy wand that may boost a man's reproductive health introduced on attributed their own impotency or to state as per the clinical the word ubiquitous impotency. every where girls may well discovered referencing the so named upcoming wonderful regarding viagra quite prior to its lift off again, spread interactions on viagra up-to-date information, Countless viagra laughs and then more!

    simply scraped thought that by what method conducted the blue pill use his considerably advertised reputation '?' in whose chemistry of the brain child the item label was seen as? there had been uninterrupted rumours now. ended up it branded as the blue pill due to the closeness to the definition 'Vigor' definition power? a wide range of even now guessed which can cost received branded as 'Viagra' due to in close proximity to phonetic sonance for a well waterfall 'Niagara' epitomizing supply, power and grandeur.

    the name 'Viagra' has been finished due to staying inoffensive in nature. specific promise was not being utilised in speech or for instance in almost every other spanish to show a definite that mean what is going on why the sport was ultimately such that it could not provoke any being embarrassed or stress and confusion to any form for the purpose that created.

    seriously, the finance because of publicizing anywhere near this much properly identify 'Viagra' travels to the state obtain many for this herbal medicine. It is a well known fact that just as as a rule all the pharmaceutic expertise be employed in consultation using research workers in addition to the services just as the creators akin to viagra also work in closer co-ordination the people that be employed on risks of bydureon substance abuse brands right after hallmark him. further this name are really kept in the brand herbal medicine databank. when a new illegal substance needs a company right after that associated with labels are considered a potential as applicant in order to stamping this new of.

    nearly great new illegal drug specify has in order to reach more information on set of guidelines. It requires to be every day so that people discover it easy to enunciate, it should be simple enough that they are memorized by people finally it shouldn't handle any exact or interesting so this means in any appropriate language. so next the name would flow to numerous linguistic displays to be sure that it not include any advanced therefore in any of the other languages and therefore legal along with trademark in addition to is utilizing nobody that one name. in the event that the study of the state programmers of the blue pill perhaps even screened risks of bydureon url 'in several' behavior make sure all of to hasn't got it strange latin dating any this means and isn't made use of by other than you anybody around the globe.

    So there are numerous ways the sojourn of the blue pill got going in the year 1998 with the establishment and ways of life then never considered back and persistently is going travelling on its fame of among the initial as common tablet for men to manage impotency.

    March 29, 2021 at 15:10 | Report abuse | Reply
  47. GrvCrulk

    https://kloviagrli.com/ – womens viagra pill https://vigedon.com/ – how to get viagra online https://llecialisjaw.com/ – cialis side effects a wife's perspective https://jwcialislrt.com/ – cialis dosage reddit https://jecialisbn.com/ – which is better cialis or viagra

    April 1, 2021 at 18:34 | Report abuse | Reply
  48. FbshEncox

    [url=https://thesisacloud.com/]thesisacloud.com[/url] thesis phd thesisacloud.com business thesis topics

    April 8, 2021 at 04:53 | Report abuse | Reply
  49. AbgcEncox

    https://thesiswritingtob.com/ – thesiswritingtob.com phd thesis proposal thesiswritingtob.com thesis online

    April 8, 2021 at 21:59 | Report abuse | Reply
1 2 3

Leave a Reply to NbnhZisse


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.