Snoring and Cerebral Infarction

Partinen, Markku; Palomäki, Heikki

doi:10.1016/s0140-6736(85)92625-x

Cited by 317 publications

(112 citation statements)

References 6 publications

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“…208 Epidemiological studies suggest that habitual snoring, a possible marker for OSA, is a risk factor for brain infarction independently of confounding factors such as obesity and age. 209 Similarly, excessive daytime sleepiness identified with the Epworth Sleepiness Score was significantly associated with stroke (OR, 3.07; 95% CI, 1.65 to 6.08) in a case-control study of 181 patients. 210 The authors suggested that daytime sleepiness was possibly the consequence of OSA.…”

Section: Osa and The Origin And Progression Of Strokementioning

confidence: 92%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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Section: Osa and The Origin And Progression Of Strokementioning

confidence: 92%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…Causal relations with systemic hypertension, pulmonary hypertension, coronary artery disease, and right ventricular dysfunction are being discussed [3±8]. There also seems to be an increased risk of myocardial infarction and stroke [9,10] and it is hypothesized that this cardiovascular morbidity is responsible for a reduced cumulative survival rate in OSAS patients [11±13].…”

mentioning

confidence: 99%

Platelet function in patients with obstructivesleep apnoea syndrome

Sanner¹,

Konermann²,

Tepel³

et al. 2000

Eur Respir J

160

111

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Patients with obstructive sleep apnoea syndrome (OSAS) are subject to an increased cardiovascular morbidity including myocardial infarction and stroke. Platelets play an important role in the pathogenesis and triggering of acute cardiovascular syndromes. So far, the influence of OSAS on platelet function is not fully understood. Platelet aggregability to epinephrine, collagen, arachidonic acid, and adenosine diphosphate in vitro was measured in 17 consecutive male patients (53.0±2.1 yrs) with polysomnographically verified OSAS and compared with that of 15 male controls (50.1±3.6 yrs) at 20:00 h, 24:00 h, and 06:00 h. In addition, the long‐term effects of continuous positive airway pressure (CPAP) therapy on platelet aggregability was assessed after 6 months. Platelet aggregation in vitro induced by epinephrine showed a slight increase overnight in the untreated OSAS patients ( ns) whereas it decreased slightly ( ns) in the controls and in the treated OSAS patients. Pretherapeutic platelet aggregability was significantly lowered by CPAP therapy both at 24:00 h (64.0±6.5 versus 55.3±6.7%, p<0.05) and at 06:00 h (64.1±6.5 versus 45.8±7.6%; p=0.01). Platelet aggregability during sleep in the controls resembled that found in patients with OSAS during CPAP therapy. The results suggest that obstructive sleep apnoea syndrome contributes, at least in part, to platelet dysfunction and that long‐term continuous positive airway pressure treatment may reduce platelet aggregability.

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“…There have been many research articles demonstrating strong correlations between OSA and blood pressure changes, OSA and body mass index (BMI), OSA and Epworth sleepiness scale (ESS), and OSA with quality of life (QOL) parameters [17][18][19][20][21][22][23][24][25]. Any treatment intervention given to the OSA patient, surgical or otherwise, should address these strong correlations as they reflect the disease burden/load in the OSA patient, not just a numerical AHI criteria based on only one sleep parameter, but the entire constellation of parameters that affect the patient.…”

Section: Dear Editormentioning

confidence: 99%

The SLEEP GOAL as a success criteria in obstructive sleep apnea therapy

Pang¹,

Rotenberg

2016

Eur Arch Otorhinolaryngol

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Obstructive sleep apnea (OSA) is a common illness affecting 9 % of middle age men in North America and 3 % of women [1]. It is a debilitating disorder that affects the patients primarily at night, but manifests mainly in the daytime. The snoring at night affects not only the bedpartner's sleep quality, but may also cause break down in the marriage and relationship. Tiredness, poor concentration and irritability disrupt the snorer's quality of life, work and productivity. This seemingly innocuous five-letter word, sleep, affects the patient's mood, temper, emotional state, relationships, work performance, promotions, monthly salary and his entire being/life.Successfully and holistically treating a patient with OSA would imply reversing debilitating symptoms faced by the patient, including the metabolic and oxidative stress that accompanies the disease load and disease burden. Moreover, recent evidence has shown significant discordance between the levels of AHI used to denote outcomes of therapy and real world clinical outcomes such as QOL, patient perception of disease, cardiovascular measures, disease burden and/or survival [1][2][3][4][5]. There is a mountain of evidence showing how the AHI can vary from night to night, vary from laboratory to laboratory, from various nasal thermistor to pressure transducers, and AHI can vary based on the different definitions of hypopnea used in different laboratories and software [6][7][8][9][10][11][12][13][14]. The contemporary reliance on AHI as generally the only outcome measure assessed in research programs is not in line with many other aspects of medicine that are becoming patient centered as opposed to test centered [6][7][8][9][10][11][12][13][14].According to the surgical literature on OSA treatment, Sher's success criteria of 50 % reduction in AHI and an AHI less than 20 tend to be the benchmark for success [15]. However, this archaic concept was based entirely on an arbitrary AHI number that did not stratify the patients by likelihood of surgical success. These oft-quoted criteria should be abandoned as being both insufficient and out of date. Hobson et al. recently showed in a creative study that differences even in the definition of AHI severity cut-off can greatly influence reported efficacy of surgery in patients with OSA [16]. For example, a patient with preoperative AHI of 95 who has a post-operative PSG showing an AHI of 21, would likely experience significant symptomatic clinical improvement with a huge decrease in disease burden (in terms of obesity, hypertension, cardiovascular effects) even though they are not, by definition, considered a successful surgical outcome by the numerical AHI criteria, whereas a patient with a pre-operative AHI of 35, reduced post-operatively to under 14, is considered a successful AHI outcome even though the likelihood of clinical cardiovascular, disease burden and/or QOL impact may be minimal. It is essential that OSA treatment has clinical significance rather than satisfy some numerical criteria.When considering OSA treatm...

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Snoring and Cerebral Infarction

Cited by 317 publications

References 6 publications

Sleep Apnea and Cardiovascular Disease

Sleep Apnea and Cardiovascular Disease

Platelet function in patients with obstructivesleep apnoea syndrome

The SLEEP GOAL as a success criteria in obstructive sleep apnea therapy

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