Sleep Apnea Doubles
Stroke Risk - CPAP Treatment Data Inconclusive
The November 10th Issue of the New England Journal of
Medicine includes two articles concerning sleep apnea. One article
investigated the rate of stroke with those with obstructive sleep apnea
while the other concerned central sleep apnea.
The first study was conducted by Yale University School of Medicine
found “a new risk factor for the development of stroke”. They found
that patients with obstructive sleep apnea had double the risk for
People with obstructive sleep apnea rarely realize they have it. OSA is
a condition where the sleeper’s upper airway relaxes and closes many
times an hour. It is commonly associated with people that snore.
The worse the condition the more likely a stroke will occur. This is
the case even after all other risk factors have been considered
age, sex, race, smoking status, alcohol-consumption status,
body-mass index, and the presence or absence of diabetes
mellitus, hyperlipidemia, atrial fibrillation, and
A common treatment
for sleep apnea is the Constant Positive Air Pressure Machine (CPAP).
This applies a constant pressure on the airway keeping it open.
WebMD states that as
many as one in four men and one in 10 women have obstructive sleep apnea
There will likely
be further studies to determine if this treatment helps prevent stroke.
Earlier studies have indicated CPAP use has reduced the incidence of
The other study
published in the New England Journal of Medicine found that the CPAP did
not help people with central sleep apnea with regards to stroke
apnea is much less common and occurs when the brain simply forgets to
breath. Other studies have found that central
sleep apnea is
caused by loss of brain stem cells. This occurs naturally as we age.
This study was
less conclusive because during the study there were major advances in
the treatment of heart failure. There are patients with central apnea
that would benefit from the CPAP, but the survival rate is
Their data do not
support the use of CPAP to extend life in patients who have
central sleep apnea and heart failure. CPAP does increase
exercise capacity which is important for heart patients.
There are also
questions concerning the use of the CPAP in the studies. Some
patients may not have used the treatment for all sleeping hours.
It is important to use the CPAP for all sleeping hours to be the most
effective, even when taking a short nap.
By Dan Wilson
Best Syndication Staff Writer
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