Sleep Apnea Increases Risk of Stroke

Obstructive sleep apnea is a condition that causes the airway to narrow and become blocked during sleep.  The condition is associated with snoring, disrupted sleep, and problems breathing during sleep.  People with untreated sleep apnea wake up frequently during sleep, sometimes several hundred times a night.  As a result, the brain, other parts of the body, and other organs may not be getting enough oxygen through the night.  Lack of oxygen can contribute to heart disease, stroke, depression, worsening of ADHD (attention deficit hyperactivity disorder) symptoms, poor functioning at work and school, and motor vehicle accidents due to fatigue and inattentiveness.  Although often associated with middle aged and older men, sleep apnea also affects women and children, and often contributes to academic underachievement and behavioral problems in children and adolescents.

Recent research findings indicate that men with even mild forms of sleep apnea are at risk for stroke.  Their risk for stroke increases as the severity of the sleep apnea increases from mild to severe.  Sleep apnea more than doubles the risk of stroke in men.  Women’s risk for stroke seems to be only with severe forms of sleep apnea.  The gender differences appear to be related to an earlier onset of sleep apnea in men, and therefore an extended length of time in which the condition is untreated.  The risk of stroke then seems to be related to the cumulative effect of sleep apnea over long periods of time.

Stroke is the second leading cause of death worldwide.  There are several well known risk factors for stroke, such as age, diabetes, high blood pressure and heart problems.  There are also many cases of stroke for which the causes and contributing factors are unknown.  The recent research suggests that treating sleep apnea can prevent stroke and reduce the incidence of stroke, and supports earlier studies in which sleep apnea and stroke have been linked.  Sleep apnea has also been linked with an increased risk of high blood pressure, heart attack, irregular heartbeats, heart failure, obesity and diabetes.  

 The recent study was larger and more comprehensive than earlier ones.  Additional research is needed to determine whether treating sleep apnea does in fact reduce the risk for stroke and the incidence of stroke.  Stimulus funds and funding from the American Recovery and Reinvestment Act are being utilized to further explore the effects of sleep apnea on cardiovascular disease and to examine effective treatments for sleep apnea.

Currently, more than 12 million American adults are believed to have sleep apnea.  Most of these have undiagnosed and untreated sleep apnea.  Increased diagnosis and treatment of sleep apnea could have a profound impact on the health and well being of the population, and could have a positive impact on healthcare spending by targeting prevention of disease rather than costly treatments for disease.