Data on sleep apnea treatment decreasing strokes?

[bearinthefield]

I was reading a NIH ( US National Institute of Health) press release from April, 2010 about a study on sleep apnea and increased risk of stroke. Sleep apnea treatment reduces being tired etc, and the association of OSD and heart disease, stroke etc is clearly shown, but the press release says:

" We now have abundant evidence that sleep apnea is associated with cardiovascular risk factors and disease. The next logical step is to determine if treating sleep apnea can lower a person's risk of these leading killers".

This goes to the question of whether sleep apnea is the (proximate) cause in whole or part of stroke etc, or whether it is associated with them, like the well known other risk factors of age, gender, weight etc.

So, putting aside the known benefit of treatment for sleepiness and being tired ( car accidents etc) does anyone know of studies in the last year that support the conclusion that sleep apnea treatment does actually reduce the risk of stroke or cardiovascular disease? Any followups on the NIH study?

[JDS74]

I did a quick survey on the subject and here are some references:

CPAP Treatment Linked To Lower Mortality In Stroke Patients With OSA
http://www.sciencedaily.com/releases/20 ... 141519.htm

Influence of Continuous Positive Airway Pressure on Outcomes of Rehabilitation in Stroke Patients With Obstructive Sleep Apnea
http://stroke.ahajournals.org/cgi/conte ... /42/4/1062

Sleep and Stroke – Stanford University
http://www.stanford.edu/~davesv/Sleep%20&%20Stroke.ppt
This is a PowerPoint file and may not open correctly on every machine.

Sleep Apnea and the Cardiovascular System
http://www.acponline.org/about_acp/chap ... _burns.pdf

[bearinthefield]

Thanks JD, the first two studies you cite are on people who have already had strokes, which in and of itself adds another huge risk factor of more strokes. They seem to address the rehab process. I am not able to open the other two, but I will keep trying. I appreciate your effort.

Bear

[JDS74]

Bear:

The third citation above is to a Powerpoint presentation. If you don't have a recent version of Powerpoint, that could account for the failure to be able to open the document.

The last citation is a 'normal' PDF file. Perhaps you have an older version of the PDF viewer and downloading and installing the most recent version of Acrobat viewer will correct that problem as well.

Here is another study that discusses the relationship of stroke and OSA without providing a causal relationship.
The contents of Chest Journal seem to be generally open to the public for browsing.

http://chestjournal.chestpubs.org/conte ... /1668.full

Some more studies:

M. E. Dyken and K. B. Im
Obstructive Sleep Apnea and Stroke
Chest, December 1, 2009; 136(6): 1668 - 1677.
[Abstract] [Full Text] [PDF]

D. M. Hermann and C. L. Bassetti
Sleep-related breathing and sleep-wake disturbances in ischemic stroke
Neurology, October 20, 2009; 73(16): 1313 - 1322.
[Abstract] [Full Text] [PDF]

M. A. Martinez-Garcia, J. J. Soler-Cataluna, L. Ejarque-Martinez, Y. Soriano, P. Roman-Sanchez, F. B. Illa, J. M. M. Canal, and J. Duran-Cantolla
Continuous Positive Airway Pressure Treatment Reduces Mortality in Patients with Ischemic Stroke and Obstructive Sleep Apnea: A 5-Year Follow-up Study
Am. J. Respir. Crit. Care Med., July 1, 2009; 180(1): 36 - 41.
[Abstract] [Full Text] [PDF]

P. Jennum and R. L. Riha
Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing
Eur. Respir. J., April 1, 2009; 33(4): 907 - 914.
[Abstract] [Full Text] [PDF]

L. F. Drager, L. A. Bortolotto, E. M. Krieger, and G. Lorenzi-Filho
Additive Effects of Obstructive Sleep Apnea and Hypertension on Early Markers of Carotid Atherosclerosis
Hypertension, January 1, 2009; 53(1): 64 - 69.
[Abstract] [Full Text] [PDF]

V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
Circulation, September 2, 2008; 118(10): 1080 - 1111.
[Full Text] [PDF]

D. L. Brown, L. D. Lisabeth, M. J. Zupancic, M. Concannon, C. Martin, and R. D. Chervin
High Prevalence of Supine Sleep in Ischemic Stroke Patients
Stroke, September 1, 2008; 39(9): 2511 - 2514.
[Abstract] [Full Text] [PDF]

V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717.
[Full Text] [PDF]

C. Sahlin, O. Sandberg, Y. Gustafson, G. Bucht, B. Carlberg, H. Stenlund, and K. A. Franklin
Obstructive Sleep Apnea Is a Risk Factor for Death in Patients With Stroke: A 10-Year Follow-up
Arch Intern Med, February 11, 2008; 168(3): 297 - 301.
[Abstract] [Full Text] [PDF]

P. Lavie
Mortality in sleep apnoea syndrome: a review of the evidence
Eur. Respir. Rev., December 1, 2007; 16(106): 203 - 210.
[Abstract] [Full Text] [PDF]

A. M. Chihorek, B. Abou-Khalil, and B. A. Malow
Obstructive sleep apnea is associated with seizure occurrence in older adults with epilepsy
Neurology, November 6, 2007; 69(19): 1823 - 1827.
[Abstract] [Full Text] [PDF]

G. Parati, C. Lombardi, and K. Narkiewicz
Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk
Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1671 - R1683.
[Abstract] [Full Text] [PDF]

W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26
Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities
Eur. Respir. J., January 1, 2007; 29(1): 156 - 178.
[Abstract] [Full Text] [PDF]


Cheers,
JDS74