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 (917 Responses)
  1. South Haven Michigan Mercedes Sprinter Repair Near Me


    June 5, 2021 at 01:58 | Report abuse | Reply
  2. auto parts near me


    June 5, 2021 at 02:04 | Report abuse | Reply
  3. Mercedes Sprinter Repair Near Me W Ratings


    June 5, 2021 at 02:11 | Report abuse | Reply
  4. Mercedes Sprinter Van Abs Repair


    June 5, 2021 at 03:22 | Report abuse | Reply
  5. MileSwa

    viagra cialis melbourne site:au by cialis tablets in frankfurt pharmacy viagra and cialis

    June 5, 2021 at 04:07 | Report abuse | Reply
  6. Sprinter Window Regulator Repair

    Very nice blog post. I absolutely love this website. Stick with it!


    June 5, 2021 at 19:47 | Report abuse | Reply
  7. office supply store near me

    I used to be able to find good information from your blog posts.


    June 5, 2021 at 22:33 | Report abuse | Reply
  8. 2004 Mercedes Sprinter Engine Block Repair

    Hello there! This blog post couldnít be written much better! Going through this article reminds me of my previous roommate! He always kept preaching about this. I will send this post to him. Fairly certain he will have a very good read. Thanks for sharing!


    June 6, 2021 at 03:07 | Report abuse | Reply
  9. best auto body shop in orange county


    June 6, 2021 at 18:08 | Report abuse | Reply
  10. RV And Truck Repair Near Me

    Everything is very open with a clear explanation of the challenges. It was truly informative. Your website is very helpful. Thanks for sharing!


    June 7, 2021 at 01:23 | Report abuse | Reply
  11. Repair Shop For Mercedes Sprinter Vans


    June 7, 2021 at 01:30 | Report abuse | Reply
  12. Delsie Stutes

    This was great! I would like you to clean up all this spam though


    June 7, 2021 at 08:12 | Report abuse | Reply
  13. EncoxHtf

    cheap cialis pills online 20mg cialis online cialis 36 hour dosage

    June 7, 2021 at 08:57 | Report abuse | Reply
  14. EncoxDev

    Baclofen pre pharmacy courses online canadian king pharmacy

    June 7, 2021 at 10:58 | Report abuse | Reply
  15. food open near me


    June 7, 2021 at 16:52 | Report abuse | Reply
  16. Sprinter Black Death Repair

    Greetings! Very helpful advice in this particular post! It is the little changes that will make the largest changes. Many thanks for sharing!


    June 7, 2021 at 22:19 | Report abuse | Reply
  17. travel trailers orange county

    You're so cool! I do not believe I've read something like that before. So wonderful to discover somebody with some original thoughts on this topic. Seriously.. many thanks for starting this up. This site is something that's needed on the internet, someone with some originality!


    June 7, 2021 at 22:20 | Report abuse | Reply
  18. rv air conditioner service near me


    June 7, 2021 at 22:22 | Report abuse | Reply
  19. RV Dent Repair Orange County


    June 7, 2021 at 22:22 | Report abuse | Reply
  20. CrulkAsd

    where can i buy original cialis max cialis dose buy original cialis online

    June 8, 2021 at 03:11 | Report abuse | Reply
  21. rv camper repair near me

    After I initially left a comment I seem to have clicked the -Notify me when new comments are added- checkbox and from now on every time a comment is added I get four emails with the same comment. There has to be a way you are able to remove me from that service? Cheers!


    June 8, 2021 at 11:23 | Report abuse | Reply
  22. horse trailer paint jobs


    June 8, 2021 at 14:42 | Report abuse | Reply
  23. RV Entertainment System Los Angeles

    This blog was... how do I say it? Relevant!! Finally I have found something that helped me. Kudos!


    June 8, 2021 at 16:16 | Report abuse | Reply
  24. trailer service near me


    June 8, 2021 at 17:17 | Report abuse | Reply
  25. EncoxGtv

    rx online pharmacy mailing prescription drugs legit online pharmacy

    June 8, 2021 at 21:22 | Report abuse | Reply
  26. Internet Marketing Firm

    I need to to thank you for this good read!! I definitely enjoyed every bit of it. I have got you book marked to check out new things you postÖ


    June 9, 2021 at 03:19 | Report abuse | Reply
  27. EncoxGtv

    canadian pharmacy in lakeland fl legal online pharmacy coupon code student store pharmacy hours

    June 9, 2021 at 03:46 | Report abuse | Reply
  28. EncoxAni

    french online pharmacy canadian pharmacy review 2015 cvs pharmacy careers apply online

    June 9, 2021 at 04:48 | Report abuse | Reply
  29. CrulkAsd

    cialisi cialis dosage strengths buy cialis generic online 10 mg

    June 9, 2021 at 05:06 | Report abuse | Reply
  30. Misti Jelle


    June 9, 2021 at 11:06 | Report abuse | Reply
  31. Mac Chenot

    I absolutely love your website.. Very nice colors & theme. Did you create this web site yourself? Please reply back as Iím planning to create my own personal site and want to find out where you got this from or just what the theme is named. Thank you!


    June 9, 2021 at 11:21 | Report abuse | Reply
  32. Dale Schmerge

    Iím amazed, I must say. Rarely do I encounter a blog thatís both equally educative and engaging, and without a doubt, you've hit the nail on the head. The issue is an issue that too few people are speaking intelligently about. I am very happy I came across this in my search for something regarding this.


    June 9, 2021 at 11:22 | Report abuse | Reply
  33. Zisseloh

    cvs cialis dapoxetine cialis how long does 10mg of cialis last

    June 9, 2021 at 15:36 | Report abuse | Reply
  34. SEO Marketing Business

    An outstanding share! I have just forwarded this onto a co-worker who has been doing a little homework on this. And he actually bought me dinner due to the fact that I stumbled upon it for him... lol. So allow me to reword this.... Thanks for the meal!! But yeah, thanks for spending the time to discuss this issue here on your web page.


    June 9, 2021 at 16:09 | Report abuse | Reply
  35. Marketexchange

    Having read this I thought it was very informative. I
    appreciate you taking the time and energy to put this
    information together. I once again find myself spending a significant amount of time both reading
    and commenting. But so what, it was still worthwhile!

    June 9, 2021 at 16:19 | Report abuse | Reply
  36. Leatrice Cassino

    This website was... how do I say it? Relevant!! Finally I have found something that helped me. Thanks a lot!


    June 9, 2021 at 18:31 | Report abuse | Reply
  37. MileSwa

    cialis sales in victoria canada buy cialis without doctor prescription cialis doesn\'t work

    June 9, 2021 at 20:19 | Report abuse | Reply
  38. Mitchell Prudent

    That is a very good tip especially to those new to the blogosphere. Short but very accurate infoÖ Appreciate your sharing this one. A must read post!


    June 9, 2021 at 22:07 | Report abuse | Reply
  39. Sidney Aeschliman

    Spot on with this write-up, I seriously feel this web site needs much more attention. Iíll probably be back again to read more, thanks for the info!

    June 9, 2021 at 22:22 | Report abuse | Reply
  40. Ivan Voitier


    June 9, 2021 at 22:22 | Report abuse | Reply
  41. rv repair shop near me


    June 9, 2021 at 23:55 | Report abuse | Reply
  42. Scottie Kridler

    An interesting discussion is definitely worth comment. I believe that you ought to write more about this issue, it might not be a taboo matter but typically people do not speak about these subjects. To the next! Best wishes!!


    June 10, 2021 at 01:58 | Report abuse | Reply
  43. Kevin Erlandson


    June 10, 2021 at 08:47 | Report abuse | Reply
  44. Raymon Perun


    June 10, 2021 at 09:16 | Report abuse | Reply
  45. Julienne Lacharite

    I was very pleased to uncover this web site. I want to to thank you for your time for this particularly fantastic read!! I definitely liked every bit of it and I have you book-marked to see new information on your website.

    June 10, 2021 at 09:16 | Report abuse | Reply
  46. rv repair shop


    June 10, 2021 at 09:17 | Report abuse | Reply
  47. Lashawn Synder

    I need to to thank you for this good read!! I absolutely enjoyed every bit of it. I've got you book marked to look at new things you postÖ


    June 10, 2021 at 09:23 | Report abuse | Reply
  48. Jarred Eroh


    June 10, 2021 at 16:46 | Report abuse | Reply
  49. rv repair near me now

    When I originally commented I appear to have clicked the -Notify me when new comments are added- checkbox and from now on each time a comment is added I receive four emails with the exact same comment. Is there an easy method you are able to remove me from that service? Thank you!


    June 10, 2021 at 18:36 | Report abuse | Reply
  50. Rodolfo Gaillard

    I blog frequently and I seriously thank you for your content. The article has truly peaked my interest. I will book mark your site and keep checking for new information about once per week. I opted in for your RSS feed too.


    June 10, 2021 at 19:24 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Leave a Reply to Camper Repair Shops Near Me


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.