Journal ArticleDOI
Obstructive sleep apnea as a risk factor for stroke and death.
H. Klar Yaggi,John Concato,Walter N. Kernan,Judith H. Lichtman,Lawrence M. Brass,Vahid Mohsenin +5 more
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The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension.Abstract:
background Previous studies have suggested that the obstructive sleep apnea syndrome may be an important risk factor for stroke. It has not been determined, however, whether the syndrome is independently related to the risk of stroke or death from any cause after adjustment for other risk factors, including hypertension. methods In this observational cohort study, consecutive patients underwent polysomnography, and subsequent events (strokes and deaths) were verified. The diagnosis of the obstructive sleep apnea syndrome was based on an apnea–hypopnea index of 5 or higher (five or more events per hour); patients with an apnea–hypopnea index of less than 5 served as the comparison group. Proportional-hazards analysis was used to determine the independent effect of the obstructive sleep apnea syndrome on the composite outcome of stroke or death from any cause. results Among 1022 enrolled patients, 697 (68 percent) had the obstructive sleep apnea syndrome. At baseline, the mean apnea–hypopnea index in the patients with the syndrome was 35, as compared with a mean apnea–hypopnea index of 2 in the comparison group. In an unadjusted analysis, the obstructive sleep apnea syndrome was associated with stroke or death from any cause (hazard ratio, 2.24; 95 percent confidence interval, 1.30 to 3.86; P=0.004). After adjustment for age, sex, race, smoking status, alcohol-consumption status, body-mass index, and the presence or absence of diabetes mellitus, hyperlipidemia, atrial fibrillation, and hypertension, the obstructive sleep apnea syndrome retained a statistically significant association with stroke or death (hazard ratio, 1.97; 95 percent confidence interval, 1.12 to 3.48; P=0.01). In a trend analysis, increased severity of sleep apnea at baseline was associated with an increased risk of the development of the composite end point (P=0.005). conclusions The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension.read more
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Journal ArticleDOI
Rotating Night Shift Work and the Risk of Ischemic Stroke
Devin L. Brown,Diane Feskanich,Brisa N. Sánchez,Kathryn M. Rexrode,Eva S. Schernhammer,Lynda D. Lisabeth +5 more
TL;DR: Women appear to have a modestly increased risk of stroke after extended periods of rotating night shift work, and this risk may be confined to women with a history of 15 or more years of rotating shift work.
Journal ArticleDOI
Obesity Hypoventilation Syndrome
TL;DR: In this article, the authors describe the association between obesity and the development of chronic daytime alveolar hypoventilation, which arises from a complex interaction between sleep-disordered breathing, diminished respiratory drive, and obesity-related respiratory impairment, and is associated with significant morbidity and mortality.
Journal ArticleDOI
Day-night variation of acute myocardial infarction in obstructive sleep apnea
Fatima H. Sert Kuniyoshi,Fatima H. Sert Kuniyoshi,Arturo García-Touchard,Apoor S. Gami,Abel Romero-Corral,Christelle van der Walt,Snigdha Pusalavidyasagar,Tomas Kara,Sean M. Caples,Gregg S. Pressman,Elisardo C. Vasquez,Francisco Lopez-Jimenez,Virend K. Somers +12 more
TL;DR: The findings suggest that OSA may be a trigger for MI, and patients having nocturnal onset of MI should be evaluated for OSA, and future research should address the effects of OSA therapy for prevention of noCTurnal cardiac events.
Journal ArticleDOI
14 nights of intermittent hypoxia elevate daytime blood pressure and sympathetic activity in healthy humans
Renaud Tamisier,Jean-Louis Pépin,Judith Remy,J.-P. Baguet,J A Taylor,J. W. Weiss,Patrick Levy +6 more
TL;DR: These data are the first to show that the arterial pressure rise is sustained throughout the waking hours beyond the acute phase immediately after exposure, and may suggest that sympathoactivation induced by IH likely contributes to blood pressure elevation and may derive from reduced baroreflex inhibition.
Journal ArticleDOI
Oxidative stress--a unifying paradigm in obstructive sleep apnea and comorbidities.
TL;DR: In this article, the authors pointed out that Oxidative stress is a crucial component of obesity and metabolic disorders such as dyslipidemia and type 2 diabetes mellitus/insulin resistance, which cluster with OSA and involve inflammatory pathways as well.
References
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TL;DR: The prevalence of undiagnosed sleep-disordered breathing is high among men and is much higher than previously suspected among women, and is associated with daytime hypersomnolence.
Journal Article
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