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ByBrett Chamberlain

Apnoea sufferers are more likely to have a stroke and highly likely to experience worse outcomes after stroke, according to a recent study reported in the Journal of Stroke & Cerebrovascular Diseases. This article discusses these and associated findings from the study.

According to the study, patients who are at high risk for ischaemic heart disease should be routinely checked for obstructive sleep apnoea (OSA). Early findings from the study suggest the prevalence of OSA in this group could be as high as 60%.

The study examined the correlation of obstructive sleep apnoea with age, sex, ischaemic stroke subtype, disability and death. Patients with a high likelihood of having sleep apnoea were identified via use of the Berlin Sleep Questionnaire.

The study found that patients who had previously been diagnosed with OSA but who had not been treated were more likely to die within the first month after a stroke, when compared with those patients without obstructive sleep apnoea.

OSA is a sleep disordered breathing condition where the soft tissue of the upper airway (particularly the tongue, soft palate, uvula and pharyngeal walls) collapse across the airway when the sufferer falls into a deep state of relaxation / sleep. Each apnoeic event lasts for at least ten seconds, with some events lasting for more than a minute. A patient with severe obstructive sleep apnoea will experience at least 30 apnoeic events per hour while asleep.

This seriously disturbed breathing pattern leads directly to activation of the sypmathetic nervous system, lowered blood oxygen levels and increased strain on the heart. This, in turn, generally leads to high blood pressure and pulmonary hypertension.

A previous diagnosis of obstructive sleep apnoea and subsequent failure to undergo treatment was an independent predictor of worse functional outcomes after stroke.

The correlation between ischaemic heart disease, stroke and sleep disordered breathing has long been known, but this study goes some way toward quantifying the negative impact of apnoea and heart disease.

As always, sleep disordered breathing (whether it be a mild as simple snoring, or as serious as severe obstructive sleep apnoea) is something which should be treated, not tolereated.

If you snore or suspect you suffer from sleep apnoea, or know someone who does, arrange a sleep study to determine the exact nature and severity of the condition, then seek treatment. Based on the results of your sleep study a sleep physician will prescribe an appropriate form of therapy. This will typically by via oral appliance therapy (OAT), involving the customer fitting of a device which sits comfortably in the mouth while the patient sleeps, or via constant positive airway pressurisation (CPAP) which involves the introduction of gently pressurised air into the airway to create an ‘air splint’ which keeps the airway open.

The Sleep Therapy Clinics specialise in the diagnosis and treatment of sleep disordered breathing conditions such as snoring and obstructive sleep apnoea. For more information visit http://sleeptherapyclinic.com

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