Guidelines for the Primary Prevention of Stroke - meschia-et-al-2014-guidelines-for-the-primary-prevention-of-stroke.pdf
www.ahajournals.org/doi/pdf/10.1161/STR.0000000000000046
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Several longitudinal studies have identified sleep apnea as an independent risk factor for stroke
This cohort included 1189 subjects followed up for 4 years. There was a 3-fold increase in the risk of stroke (OR, 3.09; 95% CI, 0.74–12.81) for subjects with an AHI ≥20 events per hour.
Cognitive-behavioral interventions appear to improve CPAP adherence. 7
Patients with sleep apnea often have concomitant stroke risk factors, including hypertension, AF, diabetes mellitus, obesity, and hyperlipidemia, and several studies have dem- onstrated the importance of adjusting for these factors when examining the relationship between sleep apnea and risk of stroke
The recommended screening includes a sleep his- tory (eg, snoring, witnessed apneas, daytime sleepiness), an evaluation of conditions that may occur as a consequence of sleep apnea (eg, motor vehicle accidents, stroke), and physi- cal examination (eg, BMI ≥35 kg/m2 , neck circumference >17 in for men or 16 in for women). The Epworth Sleepiness Scale 756 and Berlin Questionnaire 757 are tools for screening for sleep apnea.
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