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Double jeopardy: sleep apnea, atrial fibrillation, and stroke
Sleep apnea disorder has been identified as a prevalent disease among adults in the US [1] and presumably in other countries too. However, it was not until the seminal studies of Henri Gastaut in France [2] and Elio Lugaresi in Italy [3] that sleep apnea began to take the shape of a serious medical disorder perhaps related to vascular and other disorders. Today we know that sleep apnea is a risk factor for stroke of large [4–6] and small blood vessels [7].
Source: Sleep Medicine - September 18, 2015 Category: Sleep Medicine Authors: Antonio Culebras Tags: Editorial Source Type: research

Double jeopardy: sleep apnea, atrial fibrillation and stroke
Sleep apnea disorder has been identified as a prevalent disease among adults in the US [1]. However, it was not until the seminal studies of Henri Gastaut in France in 1965 [2] and Elio Lugaresi in Italy in 1975 [3] that sleep apnea began to take the shape of a serious medical disorder perhaps related to vascular and other disorders. Today we know that sleep apnea is a risk factor for stroke of large [4, 5, 6] and small blood vessels [7].
Source: Sleep Medicine - September 18, 2015 Category: Sleep Medicine Authors: Antonio Culebras Tags: Editorial Source Type: research

Double jeopardy: sleep apnea, atrial fibrillation, and stroke
Sleep apnea disorder has been identified as a prevalent disease among adults in the US [1] and presumably in other countries too. However, it was not until the seminal studies of Henri Gastaut in France [2] and Elio Lugaresi in Italy [3] that sleep apnea began to take the shape of a serious medical disorder perhaps related to vascular and other disorders. Today we know that sleep apnea is a risk factor for stroke of large [4 –6] and small blood vessels [7].
Source: Sleep Medicine - September 17, 2015 Category: Sleep Medicine Authors: Antonio Culebras Tags: Editorial Source Type: research

Association of incident restless legs syndrome with outcomes in a large cohort of US veterans.
Abstract Restless legs syndrome is a common sleep disorder, but there is a paucity of large cohort studies examining the association of restless legs syndrome with clinical outcomes, including all-cause mortality, incident coronary heart disease, stroke and chronic kidney disease. From a nationally representative prospective cohort of over 3 million US veterans [93% male, median follow-up time of 8.1 years (interquartile range: 7.0-8.5 years)] with baseline estimated glomerular filtration rate ≥60 mL min(-1)  1.73 m(-2) , a propensity-matched cohort of 7392 patients was created, and the association betwee...
Source: Journal of Sleep Research - September 17, 2015 Category: Sleep Medicine Authors: Molnar MZ, Lu JL, Kalantar-Zadeh K, Kovesdy CP Tags: J Sleep Res Source Type: research

Phenotypes of comorbidity in OSAS patients: combining categorical principal component analysis with cluster analysis.
Abstract Phenotyping obstructive sleep apnea syndrome's comorbidity has been attempted for the first time only recently. The aim of our study was to determine phenotypes of comorbidity in obstructive sleep apnea syndrome patients employing a data-driven approach. Data from 1472 consecutive patient records were recovered from our hospital's database. Categorical principal component analysis and two-step clustering were employed to detect distinct clusters in the data. Univariate comparisons between clusters included one-way analysis of variance with Bonferroni correction and chi-square tests. Predictors of pairwise...
Source: Journal of Sleep Research - September 14, 2015 Category: Sleep Medicine Authors: Vavougios GD, Natsios G, Pastaka C, Zarogiannis SG, Gourgoulianis KI Tags: J Sleep Res Source Type: research

Self-reported obstructive sleep apnea, simple snoring, and various markers of sleep-disordered breathing as predictors of cardiovascular risk.
CONCLUSIONS: Self-reported OSA and SDB-related snoring variables are associated with cardiovascular risk, whereas simple snoring is not. In clinical practice and in surveys, questions concerning only habitual snoring should be amended with questions focusing on respiratory pauses and snoring stertorousness, which can be used to estimate the risk of OSA and cardiovascular events. PMID: 26363577 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - September 12, 2015 Category: Sleep Medicine Authors: Niiranen TJ, Kronholm E, Rissanen H, Partinen M, Jula AM Tags: Sleep Breath Source Type: research

Obstructive Sleep Apnea is Related to Impaired Cognitive and Functional Status after Stroke
Conclusions:Obstructive sleep apnea (OSA) is associated with a lower cognitive and functional status in patients admitted for stroke rehabilitation. This underlines the importance of OSA as a probable prognostic factor, and calls for well-designed randomized controlled trials to study its treatability.Citation:Aaronson JA, van Bennekom CA, Hofman WF, van Bezeij T, van den Aardweg JG, Groet E, Kylstra WA, Schmand B. Obstructive sleep apnea is related to impaired cognitive and functional status after stroke. SLEEP 2015;38(9):1431–1437.
Source: Sleep - September 1, 2015 Category: Sleep Medicine Source Type: research

The Sleep Apnea cardioVascular Endpoints (SAVE) Trial: Rationale, Ethics, Design, and Progress
This article describes the rationale for the SAVE study, considerations given to the design including how various cultural and ethical challenges were addressed, and progress in establishing and maintaining the recruitment network, patient follow-up, and adherence to CPAP and procedures. The assumptions underlying the original trial sample size calculation and why this was revised downward in 2012 are also discussed.Clinical Trials Registration Number:NCT00738179.Australia New Zealand Clinical Trials Registry Number:ACTRN12608000409370.Citation:Antic NA, Heeley E, Anderson CS, Luo Y, Wang J, Neal B, Grunstein R, Barbe F, L...
Source: Sleep - August 1, 2015 Category: Sleep Medicine Source Type: research

RLS and PLMS: an avenue toward better understanding the natural history and spectrum of cerebrovascular disease?
In an article in this issue of Sleep Medicine, Gupta et al. reported the prevalence of Restless Legs Syndrome (RLS) prior to stroke onset in 346 first-ever stroke survivors, both hemorrhagic and ischemic, in an observational cohort in New Delhi, India. RLS was diagnosed retrospectively based on International Restless Legs Syndrome Study Group (IRLSSG) criteria and correlated with stroke characteristics such as location – subcortex versus cortex – and arterial territory (based on computed tomography or magnetic resonance imaging).
Source: Sleep Medicine - July 29, 2015 Category: Sleep Medicine Authors: Sravani V. Mudumbi Tags: Editorial Source Type: research

RLS and PLMS, an avenue toward better understanding the natural history and spectrum of cerebrovascular disease?
In an article in this issue of Sleep Medicine, Gupta et al report prevalence of Restless Legs Syndrome (RLS) prior to stroke onset in 346 first-ever stroke survivors, both hemorrhagic and ischemic, in an observational cohort in New Delhi, India. RLS was diagnosed retrospectively based on International Restless Legs Syndrome Study Group (IRLSSG) criteria and correlated with stroke characteristics such as location–subcortex versus cortex and arterial territory based on Computed Tomography or Magnetic Resonance Imaging).
Source: Sleep Medicine - July 29, 2015 Category: Sleep Medicine Authors: Sravani V. Mudumbi Tags: Editorial Source Type: research

Restless legs syndrome, a predictor of subcortical stroke: A prospective study in 346 stroke patients
• Restless legs syndroome (RLS), especially unilateral or asymmetrical, might commonly pre-exist in patients presenting with subcortical stroke.• The common laterality may suggest an important predictive value for RLS and may form an important point for future research.• RLS and stroke relationship were convincingly highlighted.• Observations may yield prognostic value for RLS among patients with common risk factors for stroke.
Source: Sleep Medicine - July 20, 2015 Category: Sleep Medicine Authors: Anupama Gupta, Garima Shukla, Afsar Mohammed, Vinay Goyal, Madhuri Behari Tags: Original Article Source Type: research

Restless legs syndrome, a predictor of subcortical stroke: a prospective study in 346 stroke patients
Restless legs syndrome (RLS), first described by Ekbom in 17th century, is a common sleep-related movement disorder [1]. RLS is characterized by four essential criteria established by the International Restless Legs Syndrome Study Group (IRLSSG) [2]: namely, an urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs; beginning or worsening during periods of rest or inactivity, such as lying down or sitting; partial or total relief by movement, such as walking or stretching, at least as long as the activities are continued; and worsening in the evening or at night as compa...
Source: Sleep Medicine - July 19, 2015 Category: Sleep Medicine Authors: Anupama Gupta, Garima Shukla, Afsar Mohammed, Vinay Goyal, Madhuri Behari Tags: Original Article Source Type: research

Infarct location and sleep apnea: evaluating the potential association in acute ischemic stroke
• The relationship between infarction location and sleep apnea was examined.• Obstructive sleep apnea (OSA) is present in the majority of stroke patients.• Infarct location cannot reliably be used to identify a higher risk of OSA.• There are no clearly identifiable OSA predictive factors in acute stroke patients.• Polysomnography should be considered in all acute stroke patients.
Source: Sleep Medicine - July 16, 2015 Category: Sleep Medicine Authors: Stephanie M. Stahl, H. Klar Yaggi, Stanley Taylor, Li Qin, Cristina S. Ivan, Charles Austin, Jared Ferguson, Radu Radulescu, Lauren Tobias, Jason Sico, Carlos A. Vaz Fragoso, Linda S. Williams, Rachel Lampert, Edward J. Miech, Marianne S. Matthias, John K Tags: Original Article Source Type: research

Risk of Cardiovascular Disease Associated with a Restless Legs Syndrome Diagnosis in a Retrospective Cohort Study from Kaiser Permanente Northern California
Conclusion:Primary restless legs syndrome (RLS) was not associated with new-onset cardiovascular disease (CVD) or coronary artery disease (CAD) but was associated with a slight increased risk of hypertension. In contrast, secondary RLS was associated with an increased risk of CVD, CAD, and hypertension.Citation:Van Den Eeden SK, Albers KB, Davidson JE, Kushida CA, Leimpeter AD, Nelson LM, Popat R, Tanner CM, Bibeau K, Quesenberry CP. Risk of cardiovascular disease associated with a restless legs syndrome diagnosis in a retrospective cohort study from Kaiser Permanente Northern California. SLEEP 2015;38(7):1009–1015.
Source: Sleep - June 30, 2015 Category: Sleep Medicine Source Type: research

Dynamic changes in sleep-related breathing abnormalities in bilateral paramedian mesencephalon and thalamus stroke: a follow-up case study.
CONCLUSION: In addition to the structural abnormality of the sleep regulating network, sleep-disordered breathing is another possible cause of hypersomnia in patients afflicted with the present localization of the lesion. PMID: 26070534 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - June 13, 2015 Category: Sleep Medicine Authors: Faludi B, Tóth M, Pusch G, Komoly S Tags: Sleep Breath Source Type: research

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