Treating sleep apnea may improve stroke outcomes

If treatment of sleep apnea occurs immediately after a stroke or mini-stroke, new research shows that it may improve patients’ neurological symptoms and daily functioning. More than 20 million adults in the U.S. have obstructive sleep apnea, which has been linked with increased risk for heart attack, hypertension, sudden death, stroke and faster progression of cardiovascular disease.

In a recent study, researchers found that stroke patients who were diagnosed with sleep apnea saw greater improvements in both neurological symptoms and daily ability to function when they used treatment for OSA. This was in comparison to patients with sleep apnea who only received typical medical care.

Sleep apnea and stroke

The study looked at 252 adults that were hospitalized for an ischemic stroke or a mini-stroke, which is known as a transient ischemic attack (TIA). Every participant was screened for sleep apnea. Researchers found that three-quarters of patients had sleep apnea and about two-thirds of those patients with sleep apnea were assigned to one of two interventions that included receiving CPAP therapy, training and encouragement. The other one-third with sleep apnea served as a control group and received usual medical care, plus recommendation at the end of the study to seek CPAP treatment.

Patients’ neurological symptoms and their ability to function in normal activities, such as walking and self care, were assessed at the beginning of the study and six months to one year later. At follow-up, all patients experienced improvement in both neurological symptoms and functional status. However, 59 percent of the patients who used CPAP had neurological symptoms scores at or close to normal. This was in contrast to 38 percent who had just received typical medical care.

If you treat sleep apnea early, the better your stroke outcome will be. Contact Dr. Mayoor Patel to discuss this further. What are some ways to help your patients now and in the future? My guess is that we will need to continue to build upon our relationships with physicians in our communities.

The Added Dangers for Women with Sleep Apnea

Sleep apnea can be a dangerous disease if it is not properly treated. As stated by The New York Times, a recent study indicated that sleep apnea may be even more dangerous for women than for men. With this new study, it is important to pay close attention to sleep apnea if you currently suffer from it and are a woman. However, it is still important as a man to receive treatment as well. Let’s take a look at why women may have added dangers when suffering from sleep apnea.

Heart Disease

Epidemiological studies have linked sleep apnea to heart disease in men, but the differences in risk between men and women were often overlooked. In this study quoted by The New York Times, researchers measured sleep quality electronically in 737 men and 879 women with the average age of 63 who were free of cardiovascular disease at the start of the study. This study also tested each person for troponin T, which is a protein that can be released into the bloodstream if the heart is damaged. When this is present in otherwise healthy people, it often indicates an increased risk for heart disease.

Each participant was tracked for 14 years and incidents of coronary artery disease, heart failure and death from cardiovascular disease or other causes were recorded throughout the process. Once completed, this study was published in Circulation.

What We Learned

Through this study, we learn that obstructive sleep apnea was independently associated with increased troponin T, heart failure and death in women, but not in men. Strange, right? Additionally, in women, but not in men, sleep apnea was associated with an enlarged heart, which is another risk factor for cardiovascular disease. As we already know, most people with sleep apnea already have an increased risk of heart disease, but in women the relationship is stronger—persisting even after accounting for the other risks. Even if women with sleep apnea do not get heart failure, it is associated with changes in the heart that lead to worse outcomes.

So, what do we do with these results? The same thing we have been doing all along—helping our patients find the care they need in order to protect them from harm. Please contact me if you have any questions about sleep apnea and the increased risk for women as well as other patients.