Sleep Apnea & Stroke
The symbiotic relationship you need to know about
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wenty years ago, you would be hard pressed to find data on sleep apnea’s connection to stroke. Even ten years ago it may have been difficult to find supporting data to clarify the association. But today, we are fortunate enough to have dedicated researchers and sleep experts working to let everyone know—sleep apnea and stroke have a well-documented connection that should not be ignored. Karl Doghramji, MD is the Medical Director of Jefferson Sleep Disorders Center in Philadelphia specializing in Sleep Disorders Medicine. “Several years ago, I began noticing a high prevalence of sleep apnea among incoming stroke patients,” Dr. Doghramji begins. “After searching out national data and examining sleep apnea rates in our own stroke patients, I became involved with the Sleep Stroke Study Group.” This international group is a growing medical community comprised of sleep and stroke researchers Dr. Karl Doghramji from around the world. “From there, I focused on post-stroke outpatients,” Dr. Doghramji explains. “We wanted to know—could implementing treatment for sleep apnea in post-stroke patients prevent a future stroke?” 20 | healthiersleepmag.com
EXPLAINING THE CONNECTION A number of long-term studies spanning six or more years have concluded that leaving sleep apnea untreated in an individual who has had a stroke increases the risk of having a second stroke. Dr. Doghramji cites those living with untreated severe sleep apnea have a three-fold risk of a repeat stroke. “If the connections between sleep apnea and stroke do not seem apparent, it may help to think about it like this — sleep apnea promotes the right biological environment for a stroke; it is very ‘pro-stroke.’ Stroke is a thrombotic vascular build-up of plaque that forms in an artery supplying blood to your brain. Sleep apnea promotes that process by lowering blood oxygen
levels, increasing heart rhythm disturbances, increasing blood pressure…essentially, sleep apnea is the fire in the oven of stroke.” UNDERSTANDING THE OPTIONS Treating sleep apnea, especially when severe, may lower the risk of stroke. But for patients who have already lived through a stroke episode, CPAP machines and other forms of treatment may not be well-tolerated. “Post-stroke patients often suffer with daytime sleepiness, weakened cognitive function and physical impairments that make using a CPAP difficult. Currently, we are studying a different form of treatment, which may one day be applied to stroke patients.
