Purpose Of Review: Stroke and sleep apnea are highly prevalent conditions with a physiologically plausible bidirectional relationship. This review addresses prestroke sleep apnea, wake-up stroke and sleep apnea, and poststroke sleep apnea, with an attempt to highlight research published in the last 18 months.
Recent Findings: Sleep apnea is highly prevalent poststroke. Poststroke sleep apnea is associated with worse poststroke functional and cognitive outcomes and a higher risk of recurrent stroke. Physiologic tests are needed to diagnose sleep apnea in poststroke patients as sleep apnea questionnaires do not perform well in this population. The role of CPAP in poststroke management is not yet well established.
Summary: Sleep apnea is a well established independent risk factor for stroke that confers an approximately two-fold increased risk of incident stroke. Sleep apnea is highly prevalent poststroke and is associated with worse outcomes after stroke. Sleep apnea is an attractive target for research addressing secondary stroke prevention and recovery.
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http://dx.doi.org/10.1097/WCO.0000000000000781 | DOI Listing |
Hypertens Res
January 2025
School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; #155 Section 2, Linong Street, Taipei, 112, Taiwan.
To explore the effects of obstructive sleep apnea (OSA) on nocturnal changes in blood pressure (BP), we enrolled 2037 participants who underwent polysomnography (PSG) between 2019 and 2020 and examined BP changes before and after sleep. BP was measured in the evening and the following morning using an electronic wrist sphygmomanometer in the supine position. The severity of OSA was determined by PSG and graded based on the apnea/hypopnea index (AHI).
View Article and Find Full Text PDFNat Med
January 2025
Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel.
Sleep tests commonly diagnose sleep disorders, but the diverse sleep-related biomarkers recorded by such tests can also provide broader health insights. In this study, we leveraged the uniquely comprehensive data from the Human Phenotype Project cohort, which includes 448 sleep characteristics collected from 16,812 nights of home sleep apnea test monitoring in 6,366 adults (3,043 male and 3,323 female participants), to study associations between sleep traits and body characteristics across 16 body systems. In this analysis, which identified thousands of significant associations, visceral adipose tissue (VAT) was the body characteristic that was most strongly correlated with the peripheral apnea-hypopnea index, as adjusted by sex, age and body mass index (BMI).
View Article and Find Full Text PDFLancet Diabetes Endocrinol
January 2025
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
The extent to which newer, incretin-based drugs for obesity improve disease outcomes via weight loss versus the direct effects of these drugs is the subject of intense interest. Although reductions in major adverse cardiovascular events appear to be predominantly driven by the direct tissue effects of such drugs, the associated weight loss effects must be relevant to the benefits observed in other major outcomes, albeit to differing extents. In this Personal View, we draw on evidence to support that weight loss is at least partly responsible (albeit to differing extents) for the reported benefits of incretin-based drugs for obesity in people living with heart failure with preserved ejection fraction, hypertension, chronic kidney disease, and type 2 diabetes.
View Article and Find Full Text PDFSleep Breath
January 2025
Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, Prądnicka 80, Kraków, 31-202, Poland.
Background: Obstructive sleep apnoea (OSA) may lead to heart rhythm abnormalities including bradycardia. Our aim was to ascertain clinical and echocardiographic parameters in patients with OSA in whom severe bradycardia was detected in an outpatient setting, as well as to evaluate the efficacy of CPAP therapy on heart rate normalization at the early stages of treatment.
Methods: Fifteen patients mild, moderate or severe OSA and concomitant bradycardia were enrolled.
Urogynecology (Phila)
January 2025
From the Division of Urogynecology & Reconstructive Pelvic Surgery, Department of OB/GYN, Harbor-UCLA Medical Center, Torrance CA.
Importance: Obstructive sleep apnea (OSA) is common but likely underdiagnosed in urogynecology patients with nocturia, and OSA treatment has the potential to improve nocturia symptoms.
Objective: The aim of the study was to assess the effect of implementing a universal screening protocol for OSA in a urogynecology clinic on screening rates, OSA prevalence among patients with nocturia, and symptom improvement following treatment.
Study Design: This was an observational quality improvement study at a urogynecology clinic at a safety-net hospital.
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