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Neurological recovery after acute ischemic stroke with obstructive sleep apnea
Source: Acta Neurologica Scandinavica - January 9, 2018 Category: Neurology Authors: T. Kawada Tags: LETTER TO THE EDITOR Source Type: research

Dysphagia and Obstructive Sleep Apnea in Acute, First-Ever, Ischemic Stroke
Obstructive sleep apnea (OSA) and dysphagia are common in acute stroke and are both associated with increased risk of complications and worse prognosis. The aims of the present study were (1) to evaluate the prevalence of OSA and dysphagia in patients with acute, first-ever, ischemic stroke; (2) to investigate their clinical correlates; and (3) to verify if these conditions are associated in acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - October 23, 2017 Category: Neurology Authors: Anna Losurdo, Valerio Brunetti, Aldobrando Broccolini, Pietro Caliandro, Giovanni Frisullo, Roberta Morosetti, Fabio Pilato, Paolo Profice, Nadia Mariagrazia Giannantoni, Maria Luisa Sacchetti, Elisa Testani, Catello Vollono, Giacomo Della Marca Source Type: research

Author response: Long-term cerebral white and gray matter changes after preeclampsia
We thank Dr. Culebras for the comment on our article.1 Sleep apnea might be among the pathophysiologic pathways linking preeclampsia with increased risk of cerebrovascular disease in previously preeclamptic women. In fact, research recently focused on the role of sleep apnea in the etiopathogenesis of cerebrovascular and cardiovascular disease and demonstrated an increased stroke risk in patients with obstructive sleep apnea (OSA).2,3 Intermittent hypoxia with consecutive vascular dysregulation has been identified as a possible mechanism whereby OSA increases risk of stroke. This might be relevant to previously preeclampti...
Source: Neurology - September 18, 2017 Category: Neurology Authors: Siepmann, T., Boardman, H., Bilderbeck, A., Griffanti, L., Kenworthy, Y., Zwager, C., McKean, D., Francis, J., Neubauer, S., Yu, G. Z., Lewandowski, A. J., Sverrisdottir, Y. B., Leeson, P. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Evaluation of Cerebrovascular Reactivity in Subjects with and without Obstructive Sleep Apnea
Both obstructive sleep apnea (OSA) and altered cerebrovascular reactivity (CVR) are associated with increased stroke risk. Nevertheless, the incidence of abnormal CVR in patients with OSA is uncertain due to the high variability in the way CVR is measured both within and between studies. We hypothesized that a standardized CVR with a consistent vasoactive stimulus and cerebral blood flow (CBF) measure would be reduced in patients with severe OSA compared with healthy controls.
Source: Journal of Stroke and Cerebrovascular Diseases - September 13, 2017 Category: Neurology Authors: Clodagh M. Ryan, Anne Battisti-Charbonney, Olivia Sobczyk, David J. Mikulis, James Duffin, Joseph A. Fisher, Lashmi Venkatraghavan Source Type: research

Sleep-Disordered Breathing
ABSTRACT: Purpose of Review: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reve...
Source: CONTINUUM: Lifelong Learning in Neurology - August 1, 2017 Category: Neurology Tags: Review Articles Source Type: research

Noninvasive Ventilatory Correction in Patients With Acute Ischemic Stroke Brief Report
Conclusions—NIVC seems to be associated with greater short-term neurological improvement in acute ischemic stroke patients with obstructive sleep apnea. This finding deserves further investigation within the settings of an adequately powered, sham-control, randomized clinical trial.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Georgios Tsivgoulis, Andrei V. Alexandrov, Aristeidis H. Katsanos, Kristian Barlinn, Robert Mikulik, Vaia Lambadiari, Anastasios Bonakis, Anne W. Alexandrov Tags: Ischemic Stroke Brief Reports Source Type: research

Stroke and other cardiovascular events in patients with obstructive sleep apnea and the effect of continuous positive airway pressure
In this study, we analyzed the incidence of cardiovascular events in patients with OSA and compared for the impact of CPAP therapy. All polysomnographies performed in 2009 and 2010 were selected with an AHI ≥5 and patients older than 18 years. These 1110 patients were approached with a questionnaire about cardiovascular events and CPAP treatment. Finally, 554 patients were included in analyses. CPAP treatment was based on compliance (level 1 treatment) and extended with residual respiratory events ( level 2 treatment). OSA was set as AHI ≥5 and classified in mild (AHI 5–15), moderate (AHI 15–30) and severe (AHI â‰...
Source: Journal of Neurology - May 26, 2017 Category: Neurology Source Type: research

Probable REM sleep behavior disorder and risk of stroke: A prospective study
Conclusions: Presence of pRBD was associated with a higher risk of developing stroke, including both ischemic and hemorrhagic types. Future studies with clinically confirmed RBD and a longer follow-up would be appropriate to further investigate this association.
Source: Neurology - May 8, 2017 Category: Neurology Authors: Ma, C., Pavlova, M., Liu, Y., Liu, Y., Huangfu, C., Wu, S., Gao, X. Tags: All Cerebrovascular disease/Stroke, All Sleep Disorders, Cohort studies ARTICLE Source Type: research

Probable rapid eye movement sleep behavior disorder and risk of stroke: a prospective study (P4.302)
Conclusions:Presence of pRBD was associated with a higher risk of developing stroke, including both ischemic and hemorrhagic types. Future studies with clinically confirmed RBD and a longer follow-up would be appropriate to further investigate this association.Study Supported by: The National Institute of Neurological Disorders And Stroke at the National Institutes of Health (NINDS 5R21NS087235-02 to X.G.)Disclosure: Dr. Ma has nothing to disclose. Dr. Pavlova has received research support from Lundbeck and Biomobie Corporation. Dr. Liu has nothing to disclose. Dr. Liu has nothing to disclose. Dr. Huangfu has nothing to di...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ma, C., Pavlova, M., Liu, Y., Liu, Y., Huangfu, C., Wu, S., Gao, X. Tags: Neuroepidemiology: Cerebrovascular Disease I Source Type: research

Obstructive Sleep Apnea is Associated with Improved Ischemic Stroke Outcomes (P4.312)
Conclusions:Among inpatients diagnosed with IS, OSA was associated with lower odds of death and poor discharge status. Consistent with animal studies, ischemic preconditioning could be a mechanism by which OSA leads to better outcomes after stroke in humans.Disclosure: Dr. Low has nothing to disclose. Dr. Elkind has received personal compensation in an editorial capacity for Neurology.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Low, D., Elkind, M. Tags: Neuroepidemiology: Cerebrovascular Disease II Source Type: research

Development, Validation, and Assessment of an Ischemic Stroke or Transient Ischemic Attack-Specific Prediction Tool for Obstructive Sleep Apnea
Screening instruments for obstructive sleep apnea (OSA), as used routinely to guide clinicians regarding patient referral for polysomnography (PSG), rely heavily on symptomatology. We sought to develop and validate a cerebrovascular disease-specific OSA prediction model less reliant on symptomatology, and to compare its performance with commonly used screening instruments within a population with ischemic stroke or transient ischemic attack (TIA).
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2017 Category: Neurology Authors: Jason J. Sico, H. Klar Yaggi, Susan Ofner, John Concato, Charles Austin, Jared Ferguson, Li Qin, Lauren Tobias, Stanley Taylor, Carlos A. Vaz Fragoso, Vincent McLain, Linda S. Williams, Dawn M. Bravata Source Type: research

Neurological Deficits in Obstructive Sleep Apnea
Opinion statementObstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repetitive episodes of complete or partial obstruction of the upper airway. The prevalence of this disorder is strictly dependent on its gravity. At ≥15 events/h apnea–hypopnea index (AHI), it ranges from 6 to 17% in the general population, with higher rates in men and increasing with age. The hypoxia induced by OSA severely affects the structure and function of blood vessels, culminating in mortality and morbidity. Its negative impact influ ences also cognitive functioning. Recent papers showed the relat...
Source: Current Treatment Options in Neurology - April 3, 2017 Category: Neurology Source Type: research

Neurological Deficits in Obstructive Sleep Apnea.
Abstract OPINION STATEMENT: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repetitive episodes of complete or partial obstruction of the upper airway. The prevalence of this disorder is strictly dependent on its gravity. At ≥15 events/h apnea-hypopnea index (AHI), it ranges from 6 to 17% in the general population, with higher rates in men and increasing with age. The hypoxia induced by OSA severely affects the structure and function of blood vessels, culminating in mortality and morbidity. Its negative impact influences also cognitive functioning. Recent papers...
Source: Epilepsy Curr - April 1, 2017 Category: Neurology Authors: Ferini-Strambi L, Lombardi GE, Marelli S, Galbiati A Tags: Curr Treat Options Neurol Source Type: research

Impact of obstructive sleep apnea on neurological recovery after ischemic stroke: A prospective study
ConclusionIschemic stroke patients with OSA tend to have poor neurological and functional recovery, across all segments of stroke and OSA severity.
Source: Acta Neurologica Scandinavica - February 16, 2017 Category: Neurology Authors: D. Menon, S. Sukumaran, R. Varma, A. Radhakrishnan Tags: ORIGINAL ARTICLE Source Type: research

Stroke Epidemiology and Risk Factor Management
This article reviews the current recommendations for the management of each of these modifiable risk factors. Recent Findings: It has been documented that some blood pressure medications may increase variability of blood pressure and ultimately increase the risk for stroke. Stroke prevention typically includes antiplatelet therapy (unless an indication for anticoagulation exists), so the most recent evidence supporting use of these drugs is reviewed. In addition, emerging risk factors, such as obstructive sleep apnea, electronic cigarettes, and elevated lipoprotein (a), are discussed. Summary: Overall, secondary stroke p...
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2017 Category: Neurology Tags: Review Articles Source Type: research

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