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
Citations
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Journal ArticleDOI
Retinal vascular tortuosity in obstructive sleep apnea.
TL;DR: Increased tortuosity of the retinal vasculature may be a novel association with OSA, and a larger prospective study will be necessary to further explore this relationship and its clinical significance.
Journal ArticleDOI
Validity and Predictive Value of a Portable Two-Channel Sleep-Screening Tool in the Identification of Sleep Apnea in Patients With Heart Failure
Grietje E. de Vries,Haye H. van der Wal,Huib A. M. Kerstjens,Vincent M. van Deursen,Boudewijn Stegenga,Dirk J. van Veldhuisen,Johannes H. van der Hoeven,Peter van der Meer,Peter J. Wijkstra +8 more
TL;DR: The screening tool is useful in excluding the presence of sleep apnea in HF patients to refer only high-risk patients for more extensive polysomnography, and may potentially reduce the need for the more expensive polysOMnography.
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Reflux events and sleep: are we vulnerable?
TL;DR: This review addresses the changes in the physiologic responses to esophageal acid contact that occur during sleep as they pertain to the development of esophagitis and other complications of gastroesophagingal reflux disease.
Journal ArticleDOI
Sleep apnea and cardiovascular disease.
TL;DR: Until better evidence becomes available, testing for sleep apnea cannot be recommended as part of the routine cardiovascular disease risk assessment, nor can its treatment be recommended for the prevention or management of cardiovascular disease in asymptomatic patients.
Journal ArticleDOI
Temperature controlled radiofrequency ablation at different sites for treatment of obstructive sleep apnea syndrome: a systematic review and meta-analysis
TL;DR: TCRFTA is clinically effective in reducing RDI levels and symptoms of sleepiness in patients with OSA syndrome when directed at the base of tongue or as a multilevel procedure.
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
Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research
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Prospective study of the association between sleep-disordered breathing and hypertension.
TL;DR: A dose-response association between sleep-disordered breathing at base line and the presence of hypertension four years later was found that was independent of known confounding factors and suggest that sleep- disordered breathing is likely to be a risk factor for hypertension and consequent cardiovascular morbidity in the general population.
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Mortality by cause for eight regions of the world: Global Burden of Disease Study
TL;DR: The Global Burden of Disease Study (GBD) used various data sources and made corrections for miscoding of important diseases (eg, ischaemic heart disease) to estimate worldwide and regional cause-of-death patterns in 1990, and the estimates by cause provide a foundation for a more informed debate on public-health priorities.