Indian Journal of Sleep Medicine

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VOLUME 17 , ISSUE 1 ( January-March, 2022 ) > List of Articles

SHORT COMMUNICATION

Mechanisms that Link Obstructive Sleep Apnea to Stroke

Aishwarya Aggarwal

Keywords : Obstructive sleep apnea, Stroke

Citation Information : Aggarwal A. Mechanisms that Link Obstructive Sleep Apnea to Stroke. Indian Sleep Med 2022; 17 (1):35-36.

DOI: 10.5005/jp-journals-10069-0092

License: CC BY-NC 4.0

Published Online: 30-04-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Obstructive sleep apnea (OSA) is a chronic sleep-related breathing disorder characterized by recurrent episodes of partial or complete collapse of the upper airway during sleep, despite an ongoing effort to breathe. OSA has been demonstrated to be an independent risk factor for ischemic stroke, atrial fibrillation, arterial hypertension, coronary artery disease, and myocardial infarction. The mechanisms that link OSA to stroke include cardiac arrhythmias, autonomic dysfunction, hypertension, hypoxia, inflammation, and dyslipidemia. Treatment of OSA can lead to primary prevention of stroke and can secondarily reduce other vascular risk factors causing stroke.


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  1. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008;5(2):136–143. DOI: 10.1513/pats.200709-155MG.
  2. Osman AM, Carter SG, Carberry JC, et al. Obstructive sleep apnea: current perspectives. Nat Sci Sleep 2018;10:21–34. DOI: 10.2147/NSS.S124657.
  3. Motamedi KK, McClary AC, Amedee RG. Obstructive sleep apnea: a growing problem. Ochsner J 2009;9(3):149–153. PMID: 21603432.
  4. Boehme AK, Esenwa C, Elkind MSV. Stroke risk factors, genetics, and prevention. Circ Res 2017;120(3):472–495. DOI: 10.1161/CIRCRESAHA.116.308398.
  5. Jehan S, Farag M, Zizi F, et al. Obstructive sleep apnea and stroke. Sleep Med Disord Int J 2018;2(5):120–125. PMID: 30680373.
  6. Sharma S, Culebras A. Sleep apnoea and stroke. Stroke Vasc Neurol 2016;1(4):185–191. DOI: 10.1136/svn-2016-000038.
  7. Abboud F, Kumar R. Obstructive sleep apnea and insight into mechanisms of sympathetic overactivity. J Clin Invest 2014;124(4):1454–1457. DOI: 10.1172/JCI70420.
  8. Nagata K, Osada N, Shimazaki M, et al. Diurnal blood pressure variation in patients with sleep apnea syndrome. Hypertens Res Off J Jpn Soc Hypertens 2008;31(2):185–191. DOI: 10.1291/hypres.31.185.
  9. Walia HK, Li H, Rueschman M, et al. Association of severe obstructive sleep apnea and elevated blood pressure despite antihypertensive medication use. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 2014;10(8):835–843. DOI: 10.5664/jcsm.3946.
  10. Steiropoulos P, Kotsianidis I, Nena E, et al. Long-term effect of continuous positive airway pressure therapy on inflammation markers of patients with obstructive sleep apnea syndrome. Sleep 2009;32(4):537–543. DOI: 10.1093/sleep/32.4.537.
  11. Hurley D. Increased TNF levels found to be mechanism behind apnea-stroke link. Neurol Today 2010;10(13):13. DOI: 10.1097/01.NT.0000384113.41451.5f.
  12. Gozal D, Serpero LD, Kheirandish-Gozal L, et al. Sleep measures and morning plasma TNF-α levels in children with sleep-disordered breathing. Sleep 2010;33(3):319–325. DOI: 10.1093/sleep/33.3.319.
  13. Kanagala R, Murali NS, Friedman PA, et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation 2003;107(20):2589–2594. DOI: 10.1161/01.CIR.0000068337.25994.21.
  14. Redline S, Yenokyan G, Gottlieb DJ, et al. Obstructive sleep apnea–hypopnea and incident stroke. Am J Respir Crit Care Med 2010;182(2):269–277. DOI: 10.1164/rccm.200911-1746OC.
  15. Partinen M, Palomäki H. Snoring and cerebral infarction. Lancet Lond Engl 1985;2(8468):1325–1326. DOI: 10.1016/s0140-6736(85)92625-x.
  16. Mansukhani MP, Bellolio MF, Kolla BP, et al. Worse outcome after stroke in patients with obstructive sleep apnea: an observational cohort study. J Stroke Cerebrovasc Dis 2011;20(5):401–405. DOI: 10.1016/j.jstrokecerebrovasdis.2010.02.011.
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