Published online Feb 16, 2016. doi: 10.12998/wjcc.v4.i2.33
Peer-review started: June 17, 2015
First decision: September 29, 2015
Revised: October 14, 2015
Accepted: December 9, 2015
Article in press: December 11, 2015
Published online: February 16, 2016
The association between sleep-disordered breathing (SDB) and cardiovascular risk has been the focus of attention in recent years. Sleep disorders are emerging risk factors for cardiovascular disease and have been related to the whole spectrum of stroke, including transient ischemic attack, ischemic cerebral infarction and intracerebral haemorrhage. It has been shown that lacunar stroke or lacunar infarctions affecting the internal capsule or the protuberance are associated with a higher frequency of SDB. Acute stroke patients with associated SDB have a worse prognosis and a higher mortality as compared to patients with first-ever stroke without SDB. Preliminary studies provide evidence of the usefulness of treatment with continuous positive airway pressure when SDB is present in stroke patients.
Core tip: Sleep disorders including obstructive sleep apnea are associated with an increased risk for a number of cardiovascular diseases, notably acute cerebrovascular events. A number of studies have shown a high prevalence of sleep-related breathing disorders in patients with stroke. A decrease in cerebral perfusion and increased coagulability related to metabolic, hematological and hemodynamic changes occuring in the presence of sleep-related breathing disorders are proposed as potential mechanisms in the pathogenesis of stroke. Early diagnosis and prompt therapeutic measures, including continuous positive airway pressure are necessary to reduce the stroke risk associated with sleep disorders. Sleep-related breating disorders should be considered modifiable risk factors for stroke, although they are frequenty underdiagnosed. The relationship between sleep breathing disorders and stroke should be further investigated for improving primary and secondary stroke prevention strategies and to contribute to reduce the global burden of stroke.