Sleep Apnea and Stroke

Sleep affects brain function and may contribute to problems of the vascular system in the brain.

There is an increased incidence of stroke between 6 AM and 12 noon. Risk factors for stroke such as high blood pressure, ischemic heart disease, and diabetes are modified by sleep apnea.

There is also a relationship between the severity of sleep apnea and the odds for developing high blood pressure. Statistically, 50% of people with sleep apnea have high blood pressure, and 30% of people with high blood pressure have sleep apnea.

Recently, it has been shown that there is evidence of a causal relationship between sleep apnea and stroke. Following a stroke, patients have a high prevalence of sleep apnea that reduces the potential for rehabilitation, further increases the risk of secondary stroke, and heightens mortality.

Successful correction of sleep apnea with noninvasive positive airway pressure ventilation lowers mean blood pressure, and indirectly lowers the risk of stroke. Unfortunately, patients with stroke tolerate positive noninvasive ventilation poorly, so CPAP is often not used. Thus, other means of correcting sleep apnea need to be investigated, and may be an indication for use of an oral apppliance to help correct the apnea.