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 (704 Responses)
  1. LbsoZisse

    cialis vs viagra canadian pharmacy http://ucialisdas.com/ generic cialis express delivery

    May 14, 2021 at 16:23 | Report abuse | Reply
  2. Maserati Cost New

    An impressive share! I have just forwarded this onto a coworker who has been doing a little research on this. And he actually bought me breakfast because I discovered it for him... lol. So allow me to reword this.... Thank YOU for the meal!! But yeah, thanks for spending some time to talk about this matter here on your blog.


    May 14, 2021 at 17:08 | Report abuse | Reply
  3. real estate for sale hayden lake idaho

    Very good write-up. I absolutely love this site. Keep it up!


    May 14, 2021 at 18:28 | Report abuse | Reply
  4. Maserati Granturismo Gt

    Oh my goodness! Amazing article dude! Thanks, However I am going through difficulties with your RSS. I don’t understand the reason why I cannot join it. Is there anybody else getting the same RSS problems? Anyone who knows the answer can you kindly respond? Thanx!!


    May 14, 2021 at 18:39 | Report abuse | Reply
  5. rv refrigerator repair company

    Howdy! I could have sworn I’ve been to this blog before but after looking at many of the posts I realized it’s new to me. Anyways, I’m definitely delighted I found it and I’ll be book-marking it and checking back frequently!


    May 14, 2021 at 22:00 | Report abuse | Reply
  6. LbsoZisse

    cialis dose https://ucialisdas.com/ – buying cialis in australia mail order and cialis

    May 14, 2021 at 23:04 | Report abuse | Reply
  7. houses for sale near my house


    May 14, 2021 at 23:53 | Report abuse | Reply
  8. houses for sale hauser idaho


    May 14, 2021 at 23:59 | Report abuse | Reply
  9. Eye Doctor Ahwatukee


    May 15, 2021 at 03:28 | Report abuse | Reply
  10. Maserati 2010 Price


    May 15, 2021 at 10:33 | Report abuse | Reply
  11. red tube photo


    May 15, 2021 at 12:11 | Report abuse | Reply
  12. AnooEncox

    average age for viagra users https://llviagra.com/ – viagra sin resultados effect of viagra on woman

    May 15, 2021 at 13:24 | Report abuse | Reply
  13. 2011 Maserati


    May 15, 2021 at 17:42 | Report abuse | Reply
  14. FmrfEncox

    cialis online http://cialisee.com/ – cialis 100mg from china cialis canada purchase

    May 15, 2021 at 17:51 | Report abuse | Reply
  15. Maserati Ye


    May 15, 2021 at 18:50 | Report abuse | Reply
  16. Gold Coast Maserati

    Your style is unique in comparison to other people I've read stuff from. Many thanks for posting when you have the opportunity, Guess I will just book mark this blog.


    May 15, 2021 at 19:10 | Report abuse | Reply
  17. Social Media Marketing Pro


    May 15, 2021 at 21:21 | Report abuse | Reply
  18. LebnEncox

    drugs from canada legitimate mexican pharmacy online no rx needed pharmacy

    May 15, 2021 at 21:36 | Report abuse | Reply
  19. aika online review

    Hi, I do think this is an excellent web site. I stumbledupon it 😉 I may return yet again since i have bookmarked it. Money and freedom is the greatest way to change, may you be rich and continue to guide others.


    May 15, 2021 at 23:29 | Report abuse | Reply
  20. Aika Game

    Good article. I am dealing with some of these issues as well..


    May 16, 2021 at 01:46 | Report abuse | Reply
  21. Internet Marketing Cypress


    May 16, 2021 at 04:53 | Report abuse | Reply
  22. Digital Marketing Agency Near Me

    Good info. Lucky me I discovered your blog by chance (stumbleupon). I've book-marked it for later!


    May 16, 2021 at 07:10 | Report abuse | Reply
  23. daftar slot

    818944 926780Once I originally commented I clicked the -Notify me when new feedback are added- checkbox and now every time a remark is added I get four emails with exactly the same comment. Is there any means you possibly can remove me from that service? Thanks! 450002

    May 16, 2021 at 09:19 | Report abuse | Reply
  24. BbshMile

    does viagra help with premature ejaculation http://loxviagra.com/ viagra spray

    May 16, 2021 at 10:19 | Report abuse | Reply
  25. Maserati Ghibli Price

    I could not refrain from commenting. Perfectly written!


    May 16, 2021 at 13:59 | Report abuse | Reply
  26. Dodge Sprinter Repair Shops

    After I originally left a comment I seem to have clicked on the -Notify me when new comments are added- checkbox and from now on whenever a comment is added I get 4 emails with the exact same comment. There has to be a way you can remove me from that service? Kudos!


    May 16, 2021 at 14:10 | Report abuse | Reply
  27. Alternator Mercedes Sprinter 2016 Repair

    Howdy! I simply wish to give you a big thumbs up for the excellent info you have got here on this post. I'll be returning to your site for more soon.


    May 16, 2021 at 14:19 | Report abuse | Reply
  28. storno brzinol

    I love what you guys tend to be up too. Such clever work and reporting! Keep up the terrific works guys I've incorporated you guys to my personal blogroll.


    May 16, 2021 at 18:01 | Report abuse | Reply
  29. Dodge Sprinter Fuel Injector Repair

    Pretty! This has been an extremely wonderful post. Many thanks for supplying this information.


    May 16, 2021 at 19:09 | Report abuse | Reply
  30. Van Wheelchair Lift Repair

    Hi there! I could have sworn I’ve been to this site before but after browsing through many of the articles I realized it’s new to me. Anyways, I’m certainly happy I discovered it and I’ll be book-marking it and checking back regularly!


    May 16, 2021 at 19:17 | Report abuse | Reply
  31. Maserati X

    Great post. I am facing a few of these issues as well..


    May 16, 2021 at 20:06 | Report abuse | Reply
  32. 2000 Chevy Conversion Van Body Repair Panels

    Everything is very open with a really clear explanation of the challenges. It was definitely informative. Your website is very useful. Thank you for sharing!


    May 16, 2021 at 20:27 | Report abuse | Reply
  33. Nearest Mercedes Service Center


    May 16, 2021 at 21:53 | Report abuse | Reply
  34. Toyota Cargo Van Repair


    May 16, 2021 at 21:59 | Report abuse | Reply
  35. Maserati Granturismo Mc For Sale


    May 16, 2021 at 22:58 | Report abuse | Reply
  36. Eddy Ciers

    An outstanding share! I've just forwarded this onto a colleague who had been doing a little homework on this. And he in fact ordered me dinner because I discovered it for him... lol. So let me reword this.... Thank YOU for the meal!! But yeah, thanks for spending the time to discuss this matter here on your blog.


    May 17, 2021 at 04:19 | Report abuse | Reply
  37. FmrfEncox

    generic cialis online purchase http://cialisee.com/ cialis online without prescription

    May 17, 2021 at 06:22 | Report abuse | Reply
  38. 2500 Sprinter Van Repair


    May 17, 2021 at 07:29 | Report abuse | Reply
  39. Mercedes Sprinter Van Repair Near Me

    Wonderful post! We will be linking to this great post on our website. Keep up the good writing.


    May 17, 2021 at 08:30 | Report abuse | Reply
  40. Dodge Sprinter Repair Near Me


    May 17, 2021 at 11:22 | Report abuse | Reply
  41. Conversion Van Screen Repair


    May 17, 2021 at 12:42 | Report abuse | Reply
  42. Sprinter Van Service


    May 17, 2021 at 12:54 | Report abuse | Reply
  43. rvupgrades reviews

    Howdy! I just would like to offer you a huge thumbs up for your great information you have right here on this post. I will be returning to your site for more soon.


    May 17, 2021 at 14:20 | Report abuse | Reply
  44. RV Blinds Los Angeles

    Hi, I do believe this is an excellent site. I stumbledupon it 😉 I am going to come back once again since I book marked it. Money and freedom is the greatest way to change, may you be rich and continue to guide others.


    May 17, 2021 at 14:29 | Report abuse | Reply
  45. LebnEncox

    drug costs http://xlnpharmacy.com/ best online international pharmacies

    May 17, 2021 at 16:00 | Report abuse | Reply
  46. rv repair


    May 18, 2021 at 05:12 | Report abuse | Reply
  47. air conditioning parts stores near me

    Excellent blog you've got here.. It’s difficult to find high-quality writing like yours nowadays. I really appreciate people like you! Take care!!


    May 18, 2021 at 17:39 | Report abuse | Reply
  48. transformation training

    Excellent post. I am facing a few of these issues as well..


    May 18, 2021 at 18:31 | Report abuse | Reply
  49. heating and air conditioning school near me

    I wanted to thank you for this fantastic read!! I certainly loved every bit of it. I have got you book marked to look at new stuff you post…


    May 18, 2021 at 19:19 | Report abuse | Reply
  50. Maserati Granturismo Reviews

    Way cool! Some very valid points! I appreciate you penning this article and the rest of the website is also very good.


    May 19, 2021 at 04:25 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Post a comment


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.