Why a polysomnogram should become part of the diagnostic evaluation of stroke and transient ischemic attack

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
Madeleine Grigg-Damberger

Abstract

Neurologists need to recognize, diagnose, and treat obstructive sleep apnea (OSA) in patients with stroke or transient ischemic attack (TIA). Increasing medical evidence suggests that OSA is an independent risk factor for stroke and TIA. Stroke (or TIA) is more likely a cause, rather than a consequence, of OSA because PSG studies have shown: 1) apneas in stroke are typically obstructive, not central or Cheyne-Stokes in type; 2) apneas are just as frequent and severe in patients with either TIA or stroke; 3) OSA severity is not influenced by the acuteness or location of the stroke; 4) untreated OSA patients have more strokes, stroke morbidity, and mortality than those who are treated. OSA alone can induce hypertension, especially in younger men. A causal relationship has recently been demonstrated between OSA and hypertension. A distinctive feature of OSA-induced hypertension is loss of the normal nighttime fall in blood pressure ("nondippers"). Data from the Sleep Heart Health Study showed a dose-response association between OSA severity and the presence of hypertension 4 years later. Hypertension or ischemic heart disease usually develops in untreated patients with OSA over time without particular worsening of OSA. Studies hav...Continue Reading

References

Mar 1, 1977·Stroke; a Journal of Cerebral Circulation·J Marshall
Sep 1, 1992·Archives of Internal Medicine·P PalatiniA C Pessina
Oct 1, 1992·Stroke; a Journal of Cerebral Circulation·J KlingelhöferB Conrad
Aug 1, 1992·The American Review of Respiratory Disease·S M ScharfK Balaban
Feb 1, 1990·Circulation·N S KleimanR Roberts
Apr 1, 1989·Stroke; a Journal of Cerebral Circulation·J R MarlerM A Foulkes
Mar 1, 1986·Chest·C GuilleminaultK Melvin
Apr 1, 1985·The American Journal of Cardiology·A J WilliamsS Santiago
Oct 1, 1995·The Journal of Clinical Investigation·V K SomersF M Abboud
Jan 1, 1995·Archives of Physical Medicine and Rehabilitation·V Mohsenin, R Valor
Oct 1, 1994·Journal of Applied Physiology·C P O'DonnellP L Smith
Dec 1, 1994·American Journal of Respiratory and Critical Care Medicine·E M Bålfors, K A Franklin
Jul 1, 1994·American Journal of Respiratory and Critical Care Medicine·J T CarlsonL E Peterson
Mar 1, 1994·Annals of Internal Medicine·K M HlaJ Dempsey
Feb 4, 1993·The New England Journal of Medicine·G Mancia
Feb 1, 1996·Stroke; a Journal of Cerebral Circulation·D C GoodS Verhulst
Mar 1, 1996·Stroke; a Journal of Cerebral Circulation·M E DykenM B Zimmerman
Jan 1, 1997·American Journal of Respiratory and Critical Care Medicine·S RedlineK Spry
Jan 1, 1997·The Journal of Clinical Investigation·D BrooksE A Phillipson
May 1, 1997·American Journal of Respiratory and Critical Care Medicine·S E MartinN J Douglas
Jun 1, 1997·The American Journal of Cardiology·M C CohenM A Mittleman
Jul 1, 1997·American Journal of Respiratory and Critical Care Medicine·M KambaE Matsuda
Aug 11, 1997·Archives of Internal Medicine·T YoungJ Skatrud
Jan 28, 1998·Stroke; a Journal of Cerebral Circulation·N NetzerK P Strohl
May 22, 1998·Stroke; a Journal of Cerebral Circulation·W J Elliott

❮ Previous
Next ❯

Citations

Jul 3, 2013·Neurología : publicación oficial de la Sociedad Española de Neurología·J M Marquez-RomeroA Arauz
Feb 11, 2016·Journal of the American Society of Hypertension : JASH·Naima Covassin, Virend K Somers
Sep 16, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Maogang ChenXinfeng Liu
Aug 1, 2012·Pulmonary Medicine·Ayodeji Adegunsoye, Siva Ramachandran
Dec 3, 2011·Journal of Sleep Research·Jürgen FischerUNKNOWN Board of the European Sleep Research Society (ESRS), Regensburg, Germany
Dec 3, 2014·Critical Care Nursing Quarterly·Penelope Z Strauss
Jan 16, 2021·Nature and Science of Sleep·Xiao Lei ZhangUNKNOWN members of the Assembly of Sleep Disordered Breathing of the Chinese Thoracic Society

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Related Papers

Stroke; a Journal of Cerebral Circulation
Devin L BrownLewis B Morgenstern
Stroke; a Journal of Cerebral Circulation
D C GoodS Verhulst
The New England Journal of Medicine
Henry YaggiVahid Mohsenin
American Journal of Respiratory and Critical Care Medicine
Michael ArztT Douglas Bradley
© 2021 Meta ULC. All rights reserved