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Stroke osa

Rachel P Ogilvie, Kamakshi Lakshminarayan, Conrad Iber, Sanjay R Patel, Pamela L Lutsey
BACKGROUND: Although excessive daytime sleepiness (EDS) is a common symptom of obstructive sleep apnea (OSA), and both EDS and OSA have separately been associated with increased risk of cardiovascular disease (CVD), their joint association with CVD risk is unknown. METHODS: Among 3874 Sleep Heart Health Study (SHHS) participants without prevalent CVD, moderate to severe OSA was defined by an apnea hypopnea index (AHI) ≥ 15 on an in-home polysomnography. EDS was defined as an Epworth Sleepiness Scale score ≥11...
April 2018: Sleep Medicine
Jin Soo Kim, Seongheon Kim, Seung Hwan Lee, Hee Young Lee, Seo Young Lee, Kyoung Bin Im
BACKGROUND AND PURPOSE: The literature indicates that obstructive sleep apnea (OSA) increases the risk of ischemic stroke. However, the causal relationship between OSA and ischemic stroke is not well established. This study examined whether preexisting OSA symptoms affect the onset of acute ischemic stroke. METHODS: We investigated consecutive patients who were admitted with acute ischemic stroke, using a standardized protocol including the Berlin Questionnaire on symptoms of OSA prior to stroke...
February 28, 2018: Journal of Clinical Neurology
Gaurav Gadodia, Srikant Rangaraju, Syed A Raza, Ammar Razzak, Labib Marmarchi, Brittaine Davis, Laura Henriquez, Lynn M Trotti, David Rye, Fadi Nahab
INTRODUCTION: Obstructive sleep apnea (OSA) and periodic limb movements (PLMs) have been associated with an increased risk of cardiovascular disease. There is limited data on the relationship between OSA and PLMs with atrial fibrillation and resistant hypertension in stroke and transient ischemic attack (TIA) patients. METHODS: Consecutive stroke and TIA patients referred by a vascular neurologist for diagnostic polysomnography (PSG) from September 1, 2012 to August 31, 2015 were included in a retrospective analysis...
March 2018: Neurologist
Laura B Ponsaing, Ulrich Lindberg, Egill Rostrup, Helle K Iversen, Henrik B W Larsson, Poul Jennum
OBJECTIVE: Obstructive sleep apnea (OSA) is an independent risk factor for stroke. Little is known about the cerebrovascular hemodynamic changes during apnea. Hypercapnia occurs in apneas and hypopneas, and a reduced cerebral vasodilatory response to CO2 could compromise the cerebral blood flow (CBF). Therefore, we aimed to evaluate whether the apnea-hypopnea index (AHI) affected the cerebrovascular response to CO2 . METHODS: A total of 11 patients with OSA were compared to 16 controls...
March 2018: Sleep Medicine
Ragnhild L Tveit, Sverre Lehmann, Bjørn Bjorvatn
STUDY OBJECTIVES: The objective was to investigate the prevalence of heart attack, angina pectoris, stroke, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, asthma and obesity in relation to the presence and severity of obstructive sleep apnea. METHODS: The sample consisted of 1887 patients, with mean age of 48.6 years (range 16-83 years), referred to a university hospital on suspicion of obstructive sleep apnea. The patients filled out a questionnaire asking whether they were previously diagnosed with the comorbidities in interest...
2018: PloS One
Namita Patel, Afsaneh Raissi, Sara Elias, Maneesha Kamra, Tetyana Kendzerska, Brian J Murray, Mark I Boulos
BACKGROUND: Home sleep apnea testing (HSAT) underestimates obstructive sleep apnea (OSA) severity. Overnight oxygen desaturation has been shown to be a strong predictor of incident stroke, and may be helpful in determining which patients with lower apnea-hypopnea indices (AHIs) should be offered treatment. OBJECTIVES: To examine whether a modified definition for OSA that uses oxygen desaturation (i.e., AHI 5-14.9 per hour and lowest O2 desaturation ≤88%), as compared to an AHI ≥ 15 per hour, would impact: (1) changes in Epworth Sleepiness Scale scores post-continuous positive airway pressure (CPAP) initiation; (2) CPAP compliance rates; and (3) the accuracy of automated versus manual scoring of HSAT...
February 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Ahmed Dalmar, Maharaj Singh, Bennet Pandey, Christopher Stoming, Zoe Heis, Khawaja Afzal Ammar, M Fuad Jan, Indrajit Choudhuri, Thomas Y Chua, Jasbir Sra, A Jamil Tajik, Arshad Jahangir
Weight loss after bariatric surgery is associated with reduction in adverse cardiovascular outcomes; however, the impact of obstructive sleep apnea (OSA) on reduction of cardiovascular outcomes after bariatric surgery in morbidly obese patients is not known. We retrospectively assessed differences in cardiovascular events after laparoscopic adjustable gastric banding (LAGB)-induced weight loss in patients with and without OSA before and after propensity score matching for age, sex, body mass index (BMI), and major comorbidities between the two groups and determined predictors of poor outcomes...
February 7, 2018: Sleep
Griffin Santarelli, Sarah C DeShields, Stacey L Ishman, Michael Randall, Tina D Cunningham, Cristina M Baldassari
Objectives (1) To assess for changes in cerebral blood flow velocity in children with sickle cell disease and obstructive sleep apnea (OSA) following adenotonsillectomy. (2) To determine if clinical factors such as OSA severity affect cerebral blood flow velocity values. Study Design Case series with chart review over 10 years. Settings Two tertiary children's hospitals. Subjects and Methods Children aged 2 to 18 years with a history of sickle cell disease and OSA, as defined by an apnea hypopnea index (AHI) >1 on polysomnography, were eligible for inclusion...
January 1, 2018: Otolaryngology—Head and Neck Surgery
Alexander P Cole, Julian Hanske, Wei Jiang, Nicollette K Kwon, Stuart R Lipsitz, Martin N Kathrins, Peter A Learn, Maxine Sun, Adil H Haider, Shehzad S Basaria, Quoc-Dien Trinh
OBJECTIVES: To assess the association of TRT with thromboembolism, cardiovascular disease (stroke, coronary artery disease, and heart failure) and obstructive sleep apnea (OSA). METHODS: A cohort of 3,422 male United States military service members, retirees and their dependents, aged 40-64 was identified, who were prescribed TRT between 2006-2010 for low testosterone. Men in this cohort were matched on a 1:1 basis by age and comorbidities to men without a prescription for TRT...
January 30, 2018: BJU International
Ling Chen, Zahra Heidari Zadi, Jin Zhang, Steven M Scharf, Eung-Kwon Pae
PURPOSE: Obstructive sleep apnea (OSA) is common in pregnancy, and may compromise fetal and even postnatal development. We developed an animal model to determine if maternal OSA could have lasting effects in offspring. METHODS: Pregnant Sprague Dawley rats were exposed to reduced ambient O2 from 21 to 4-5 %, approximately once/minute (chronic intermittent hypoxia - CIH) for 8 hours/day during gestation days 3-19. Similarly-handled animals exposed to ambient air served as controls (HC)...
December 14, 2017: Journal of Applied Physiology
Hisham Alshaer, Aditya Pandya, Igor Zivanovic, Carolina Gonzaga Carvalho, Clodagh Ryan
OBJECTIVES: To evaluate if treatment with continuous positive airway pressure (CPAP) compared to usual care in stroke patients with obstructive sleep apnea (OSA) over one month reduces delta and alpha oscillations on quantitative electroencephalography (EEG) in association with improvements in cognitive or functional outcomes. METHODS: Spectral EEG analysis was performed in patients with subacute stroke and OSA randomized to usual care or CPAP treatment from a previous study...
January 9, 2018: Respiratory Physiology & Neurobiology
Stefan Thomas Kotzian, Angela Schwarzinger, Sandra Haider, Bernd Saletu, Josef Spatt, Michael Timothy Saletu
INTRODUCTION: Meta-analyses report that more than 50% of patients who had a stroke suffer from moderate to severe sleep apnoea (SA), with adherence rates to positive airway pressure (PAP) therapy of only 30%. The primary objective of this study is to determine whether PAP adherence in patients who had a stroke with obstructive sleep apnoea (OSA) can be improved by a PAP training strategy during inhospital rehabilitation combined with a telemedicine monitoring system after discharge. Further objectives are (1) to compare the validity of a non-attended level-III polygraphy with that of a level-II polysomnography (PSG) in the diagnosis of SA, (2) to compare the validity of an apnoea-hypopnoea index (AHI) yielded by the PAP device with that obtained during PSG, (3) to determine changes in nocturnal systolic blood pressure (BP) due to PAP therapy with the pulse transit time (PTT) method and (4) to assess the impact of telemonitored PAP therapy on neurorehabilitation outcome parameters...
January 9, 2018: BMJ Open
Chengjuan Xie, Ruolin Zhu, Yanghua Tian, Kai Wang
OBJECTIVE: This study aimed to conduct a meta-analysis to explore and summarise the evidence regarding the association between obstructive sleep apnoea (OSA) and the subsequent risk of vascular outcomes and all-cause mortality. METHODS: Electronic databases PubMed, Embase and the Cochrane Library were searched to identify studies conducted through May 2016. Prospective cohort studies that reported effect estimates with 95% CIs of major adverse cardiac events (MACEs), coronary heart disease (CHD), stroke, cardiac death, all-cause mortality and heart failure for different levels versus the lowest level of OSA were included...
December 22, 2017: BMJ Open
Alberto R Ramos, Pedro Figueredo, Shirin Shafazand, Alejandro D Chediak, Alexandre R Abreu, Salim I Dib, Carlos Torre, Douglas M Wallace
Obstructive sleep apnea (OSA) is a chronic and heterogeneous disorder that leads to early mortality, stroke, and cardiovascular disease (CVD). OSA is defined by the apnea-hypopnea index, which is an index of OSA severity that combines apneas (pauses in breathing) and hypopneas (partial obstructions in breathing) associated with hypoxemia. Yet, other sleep metrics (i.e., oxygen nadir, arousal frequency), along with clinical symptoms and molecular markers could be better predictors of stroke and CVD outcomes in OSA...
2017: Frontiers in Neurology
Eva Mañas, Esther Barbero, Diana Chiluiza, Aldara García, Raquel Morillo, Deisy Barrios, Miguel Ángel Martínez-García, Alicia Albalat, Irene Cano, David Jiménez
In normotensive patients with acute symptomatic pulmonary embolism (PE), the effect of undiagnosed obstructive sleep apnea (OSA) on cardiovascular (CV) outcomes lacks clarity. The Prognostic Significance of Obstructive Sleep Apnea in Patients With Acute Symptomatic Pulmonary Embolism (POPE) study is a multicenter, observational study designed to prospectively assess the prognostic significance of concomitant OSA in hemodynamically stable outpatients with acute symptomatic PE. Adult patients with acute stable PE are eligible...
December 16, 2017: Clinical Cardiology
Elliott Vichinsky
Sickle cell disease is now a chronic adult illness characterized by progressive multiorgan failure, particularly involving the brain and kidney. The etiology is multifactorial; it includes hemolysis and nitric oxide deficiency. As patients age, most experience neurologic insult. Twenty-five percent of older adults have had a clinical stroke and at least half of the population have had a silent infarct, cortical atrophy, and neurocognitive impairment. Periodic screening with neuroimaging and neurocognitive testing is recommended...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
Nilesh H Pawar, Jennifer A O'Riordan, Preeti Malik, Farhad F Vasanwala
Stroke is one of the most common causes of mortality and morbidity worldwide. Hemorrhagic stroke comprises 10-20% of strokes. Here, we present a case report of hemorrhagic stroke that may have been secondary to untreated Obstructive Sleep Apnea (OSA) in a young man with no other cardiovascular risk factors or features of metabolic syndrome. A 32-year-old man was admitted for hemorrhagic stroke. An initial thorough workup for the etiology of stroke was inconclusive. Eventually, a polysomnography was done, which demonstrated OSA suggesting that untreated OSA may have contributed to his stroke...
September 27, 2017: Curēus
Yu-Sheng Lin, Pi-Hua Liu, Pao-Hsien Chu
Background: Obstructive sleep apnea (OSA) is common in heart failure (HF) patients and exacerbates the outcome of this chronic disease. However, the frequency of HF arising from OSA is varied, with little supporting literature. Here, we aimed to clarify the incidence risk of HF and major adverse cardiac events (MACEs) in OSA patients from the Taiwan large database. Methods and Results: From 2000-2010, a total of 2699 newly diagnosed OSA patients after polysomnographic study and 13,490 non-OSA patients utilizing 1:5 matching was enrolled and followed to 2011...
November 2017: Acta Cardiologica Sinica
W Trzepizur, P Priou, N Meslier, T Urban, M C Martínez, R Andriantsitohaina, F Gagnadoux
Obstructive sleep apnea (OSA) is associated with increased cardiovascular diseases, including myocardial infarction and stroke and promotes cardiovascular risk factors including diabetes and hypertension. OSA has also been proposed to have a direct proatherogenic effects. Recent studies have investigated the role of microparticles (MPs) in the atherogenic process. MPs are small plasma membrane vesicles that can be released by a variety of vascular or blood cells and that contain membrane and cytosolic elements...
December 2017: Revue de Pneumologie Clinique
R Nisha Aurora, Ciprian Crainiceanu, Daniel J Gottlieb, Ji Soo Kim, Naresh M Punjabi
BACKGROUND: Obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep is a common disorder. Data on whether OSA that occurs predominantly during REM sleep is associated with health outcomes are limited. The present study examined the association between OSA during REM sleep and a composite cardiovascular endpoint in a community sample with and without prevalent cardiovascular disease. METHODOLOGY: Full montage home polysomnography was conducted as part of the Sleep Heart Health Study...
November 7, 2017: American Journal of Respiratory and Critical Care Medicine
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