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The mobile sleep medicine model in neurologic practice: Rationale and application
BackgroundUndiagnosed obstructive sleep apnea (OSA) is prevalent in neurological practice and significantly contributes to morbidity and mortality. OSA is prevalent in US adults and causes poor quality sleep and significant neurocognitive, cardiovascular, and cerebrovascular impairments. Timely treatment of OSA reduces cardio-cerebrovascular risks and improves quality of life. However, most of the US population has limited systematic access to sleep medicine care despite its clinical significance.FocusWe discuss the importance of systematic screening, testing, and best-practice management of OSA and hypoventilation/hypoxem...
Source: Frontiers in Neurology - October 28, 2022 Category: Neurology Source Type: research

Comment on Qian et al. 2022, effects of comprehensive swallowing intervention on obstructive sleep apnea and dysphagia after stroke: A randomized controlled trial
Dear Editor,
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2022 Category: Neurology Authors: Emma S Wallace, Ankita Bhutada, Kendrea L Garand Tags: Letter to the Editor Source Type: research

Stroke: What's Sleep Got to Do With It?
Summary: Ischemic strokes most often occur between 6 am and 12 am after awakening from sleep but up to 30% occur during sleep. Wake-up strokes (WUS) are new focal neurological deficit(s) persisting for ≥ 24 hours attributable to an ischemic event present on patient awakening. Obstructive sleep apnea (OSA) is a major risk factor for WUS because it compounds the instability of the morning environment and increases the likelihood of cardiovascular events, including hypertension, atrial fibrillation, right-to-left shunts, and stroke. Circadian-driven alterations in structural, homeostatic, and serological factors also pr...
Source: Journal of Clinical Neurophysiology - July 1, 2022 Category: Neurology Tags: Invited Review Source Type: research

Effects of Comprehensive Swallowing Intervention on Obstructive Sleep Apnea and Dysphagia After Stroke: A Randomized Controlled Trial
Sleep-disordered breathing (SDB) is a global disorder and obstructive sleep apnea (OSA) is its most common form.1 The well-known complications of untreated OSA are increased risks of stroke, and 57% of stroke patients with OSA often experience fatigue and sleepiness during the day, which may influence cognitive function, social relationship, and quality of life.2,3 In addition, stroke patients with OSA had an increased risk of death.4,5 Therefore, it is important to identify therapies for poststroke OSA.
Source: Journal of Stroke and Cerebrovascular Diseases - May 26, 2022 Category: Neurology Authors: Surong Qian, Xiaomin Zhang, Tong Wang, Lixia Zhang, Cuiqin Hu, Ruidong Jia, Ling Zhang, Xiangrong Li, Lixiang Yan, Yan Zhang, Jinrong Zhang, Ping Yuan Source Type: research

Cardiovascular Outcomes in Sleep-Disordered Breathing: Are We Under-estimating?
Obstructive sleep apnea is a growing health concern, affecting nearly one billion people worldwide; increasingly recognized as an independent cardiovascular risk factor associated with incident obesity, insulin resistance, hypertension, arrhythmias, stroke, coronary artery disease, and heart failure. The prevalence of obstructive sleep apnea could be underestimated in the previous studies, leading to only modest predictions of cardiovascular outcomes. Using more physiologic data will increase sensitivity for the diagnosis of obstructive sleep apnea. Individuals at high risk of obstructive sleep apnea should be identified s...
Source: Frontiers in Neurology - March 15, 2022 Category: Neurology Source Type: research

Abnormalities of the Vertebrobasilar Arterial System Leading to Sleep Disorders
The abnormalities in the vertebrobasilar arterial system such as enlarged, tortuous or dilated arteries and aneurysms can generate pressure and distortion of brain structures especially in the medulla and pons. This brainstem compression by abnormal arteries can lead to various sleep disorders such as sleep related hypoventilation, central sleep apnea, obstructive sleep apnea, and positional sleep apnea.
Source: Journal of Stroke and Cerebrovascular Diseases - February 18, 2022 Category: Neurology Authors: Cameron Sabet, Aishwarya Aggarwal Tags: Short Communication Source Type: research

The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta-analysis
ConclusionOSA is considered a cardiovascular risk factor. There is a relationship between the severity of OSA and the risk of cardiovascular disease. OSA increases the risk of heart attack, CHD, and death from cardiovascular disease.
Source: Neurological Sciences - November 19, 2021 Category: Neurology Source Type: research

Sleep Apnea Linked to Lower Stroke Mortality After Thrombectomy Sleep Apnea Linked to Lower Stroke Mortality After Thrombectomy
Obstructive sleep apnea is paradoxically associated with lower risk for mortality and in-hospital complications after thrombectomy for acute ischemic stroke, new research suggests.Medscape Medical News
Source: Medscape Neurology and Neurosurgery Headlines - October 21, 2021 Category: Neurology Tags: Neurology & Neurosurgery News Source Type: news

Investigating the Association between Wake-Up Stroke and Obstructive Sleep Apnea: A Meta-Analysis
Conclusion: WUS patients have severer SDB problems compared to NWUS patients suggesting that respiratory events during sleep might be underlying the induction of WUS. Besides, the induction of WUS was significantly associated with men rather than women. Therefore, early diagnosis and management of potential WUS patients should benefit from the detection of SDB status and respiratory effects.Eur Neurol
Source: European Neurology - September 9, 2021 Category: Neurology Source Type: research

Wake ‐up strokes are linked to obstructive sleep apnea and worse early functional outcome
ConclusionModerate-to-severe OSA is related to WUS compared to non-WUS. In addition, WUS have worse short-term outcomes measured in mRS. Further studies are needed to determine if OSA is causally linked to WUS.
Source: Brain and Behavior - July 22, 2021 Category: Neurology Authors: Tuuli ‐Maria Haula, Juha Puustinen, Mari Takala, Anu Holm Tags: ORIGINAL RESEARCH Source Type: research

Snoring Is Associated With Increased Risk of Stroke: A Cumulative Meta-Analysis
Conclusions: Snoring is associated with a significantly increased risk for stroke, up to 46%. The importance of the current study lies in that we provide an imputes to take a more active approach against the increased risk of stroke in snorers.
Source: Frontiers in Neurology - April 1, 2021 Category: Neurology Source Type: research

Trazodone improves obstructive sleep apnea after ischemic stroke: a randomized, double-blind, placebo-controlled, crossover pilot study
ConclusionsObstructive sleep apnea with comorbid ischemic stroke may be a distinctive phenotype which responds quite well to trazodone, decreasing OSA severity without increasing nocturnal hypoxia.Trial RegistrationClinicaltrials.gov: NCT04162743, 2019/11/10.
Source: Journal of Neurology - February 24, 2021 Category: Neurology Source Type: research

The Bidirectional Relationship Between Obstructive Sleep Apnea and Chronic Kidney Disease
Sleep apnea is a condition with significant health risks and increased risk of mortality and is prevalent in patients with chronic kidney disease. This paper describes the detrimental cardiovascular sequelae of sleep-disordered breathing and explores the bidirectional relationship between chronic kidney disease and obstructive sleep apnea. Obstructive sleep apnea-related hypoxia produces a range of harmful systemic effects including oxidative stress, inflammation, and sympathetic activation that collectively worsen the progression of renal disease.
Source: Journal of Stroke and Cerebrovascular Diseases - February 16, 2021 Category: Neurology Authors: Lily Hui, Ruth Benca Source Type: research

Clinician-Focused Overview and Developments in Polysomnography.
Abstract Purpose of Review: Polysomnography (PSG) represents a fundamental diagnostic tool used in the evaluation of sleep disorders. It represents a simultaneous recording of sleep staging, eye movements, electromyographic tone, respiratory parameters, and electrocardiogram. It is particularly helpful in the assessment of sleep-disordered breathing and its management, propensity for excessive sleepiness, complex behaviors during sleep, including motor disturbances of sleep, sleep-related epilepsy, and parasomnias. This review is intended to summarize the indications for PSG, the limitations and challenges of this...
Source: Epilepsy Curr - November 23, 2020 Category: Neurology Authors: Markun LC, Sampat A Tags: Curr Sleep Med Rep Source Type: research

Investigation of Sleep Breathing Disorders in Young Patients (Under 55 years) with Mild Stroke
Many patients with stroke also have sleep breathing disorders (SBD), most of which is obstructive sleep apnea (OSA).
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2020 Category: Neurology Authors: Assoc. Prof. Dr. Aysin Kisabay Ak, Specialist Dr. Ay şegül Şeyma Sarıtaş, Specialist Dr. Melike Batum, Assoc. Prof. Dr. Tuğba Göktalay, Prof. Dr. Gönül Dinç Horasan, Prof. Dr. Deniz Selcuki, Prof. Dr. Hikmet Yilmaz Source Type: research

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