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Canadian Journal of Cardiology

Sleep Apnea and Stroke

Published:March 14, 2015DOI:https://doi.org/10.1016/j.cjca.2015.03.014

      Abstract

      Stroke is the second leading cause of death worldwide and often has devastating consequences for affected individuals in terms of chronic disability. Traditional risk factors such as age, male sex, ethnicity, hypertension, and atrial fibrillation explain 60%-80% of the risk of stroke. Obstructive sleep apnea (OSA) is highly prevalent in individuals who have had a stroke and its emerging role as a potential modifiable risk factor for stroke has been recognized in the most recent American Heart Association stroke guidelines, which recommend consideration of screening for and treatment of OSA in this regard. In this article we provide an overview of the current evidence-based knowledge related to stroke and sleep apnea. The main focus of this article is key pathophysiological mechanisms by which OSA might increase the risk for stroke. The effect of OSA on stroke outcomes and the efficacy of treatment of OSA on these outcomes is also discussed.

      Résumé

      L’accident vasculaire cérébral est la deuxième plus importante cause de décès dans le monde, et souvent, ses conséquences en ce qui concerne l’incapacité à long terme des individus touchés sont dévastatrices. Les facteurs de risque traditionnels comme l’âge, le sexe masculin, l’ethnicité, l’hypertension et la fibrillation auriculaire expliquent 60 % à 80 % du risque d’accident vasculaire cérébral. L’apnée obstructive du sommeil (AOS) est très fréquente chez les individus ayant eu un accident vasculaire cérébral. Son rôle émergent en tant que facteur de risque modifiable potentiel a été reconnu dans les plus récentes lignes directrices en matière d’accident vasculaire cérébral de l’American Heart Association, qui recommandent de considérer le dépistage et le traitement de l’AOS à cet égard. Dans cet article, nous donnons un aperçu des connaissances actuelles fondées sur des données probantes qui sont liées à l’accident vasculaire cérébral et à l’apnée du sommeil. Le point central de cet article porte sur les mécanismes physiopathologiques principaux par lesquels l’AOS augmenterait le risque d’accident vasculaire cérébral. Nous discutons également des conséquences de l’AOS sur les résultats de l’accident vasculaire cérébral et de l’efficacité du traitement de l’AOS sur ces résultats.
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