How Sleep Apnea Causes Strokes

Study shows how sleep apnea may cause stroke

WASHINGTON (Reuters) - A dangerous type of snoring known as sleep apnea can cause stroke by decreasing blood flow, raising blood pressure and harming the brain's ability to modulate these changes, researchers reported on Tuesday.

By ReutersJanuary 7, 2009

WASHINGTON (Reuters) - A dangerous type of snoring known as sleep apnea can cause stroke by decreasing blood flow, raising blood pressure and harming the brain's ability to modulate these changes, researchers reported on Tuesday.

The study may help explain why people with sleep apnea are more likely to have strokes and to die in their sleep, the team led by Vahid Mohsenin of Yale University in Connecticut said.

An estimated 18 million Americans have sleep apnea, which is characterized by repeated episodes in which someone who is sleeping stops breathing.

"Three years ago we showed that patients with sleep apnea ... they die or have strokes three times more than people with a comparable age or risk factors without sleep apnea," Mohsenin said in a telephone interview.

"We asked the question of why they have a higher risk for stroke."

Writing in the Journal of Applied Physiology, Mohsenin and colleagues said they tested 48 middle-aged men and women, 22 of whom had sleep apnea but who were otherwise healthy. They checked blood pressure and used ultrasound to monitor blood flow in the brain.

They had the volunteers do a blood pressure test in which they squatted and then stood suddenly.

"We found that patients with sleep apnea had difficulty compensating for the change in blood pressure," Mohsenin said. "They actually had decreased blood flow to brain."

He said this showed the damage caused by sleep apnea continues throughout the day.

"When you are up and around and experience changes in your blood pressure, or during the night when you have fluctuations in blood pressure due to apnea, they have a hard time compensating for that," Mohsenin said.

"It is a carryover effect."

Now, Mohsenin said, his team will test whether statin drugs, known to reduce inflammation, can restore the lost brain function in sleep apnea sufferers.

The patients will also later be treated using airway pressurization masks, or CPAP.

"The important thing is to recognize sleep apnea early on so there won't be any significant damage to the brain," he said.

During sleep apnea episodes, the upper airway becomes blocked, hindering or stopping breathing and causing blood oxygen levels to drop and blood pressure to rise. The person eventually awakens and begins breathing, restoring normal blood oxygen and blood flow to the brain.

Symptoms of sleep apnea include feeling tired and needing a nap even after eight hours of sleep, loud snoring that disturbs others and snorting that indicates breathing has stopped.

Using an airway pressurization mask can help the brain restore normal function, Mohsenin said, although no study has shown it lowers the rate of strokes.

(Reporting by Maggie Fox; Editing by Julie Steenhuysen)

© (c) CanWest MediaWorks Publications Inc.

Source: http://www.canada.com/topics/bodyandhea ... dfe1a5b4c7

This article implies that the health problems caused by sleep apnea are due to low blood oxygen levels. My sleep study showed my blood oxygen level to be normal all night even though I had a lot of apnea events. I have been using cpap for about 3 weeks. I'm using it 7+ hours a night and seeing an AHI between 0.5 and 2.0, but I don't feel any better. So I'm having trouble being motivated to keep using it.

My question is: are there long term heath consequences of sleep apnea if blood oxygen levels are good?

aland wrote: ........
My question is: are there long term heath consequences of sleep apnea if blood oxygen levels are good?

Aland, Good question.

Here are some other things that sleep apnea very often does:

-Frequent arousals leading to sleep deprivation and poor sleep architecture (insuffficient short-wave and REM sleep) leading to a myriad of health problems and shortened life span.
-Hormonal response pumping excess adrenalin and cortisol into the blood stream creating a high risk for heart disease, atherosclerosis, stroke, type 2 diabetes, depression and anxiety.
-Zombie-like quality of life.

it may take awhil for you to feel better again, took me about 6 weeks

They make it sound like sleep apnea and its related problems are a new found problem it seems to me. At least it is good it is getting more attention.

Gale Hawkins wrote:They make it sound like sleep apnea and its related problems are a new found problem it seems to me. At least it is good it is getting more attention.

I just met a bright 86-year old lady at lunch. She had heard I have sleep apnea and told me that she is only able to sleep about four hours each night and when she gets up in the morning she feels exhausted. She goes to her PCP regularly and he keeps telling her, "Four hours of sleep is all you can expect at your age and it is enough." I referred her directly to a sleep lab.

There is a tremendous amount of ignorance of sleep apnea in the medical profession.

rooster wrote: . . . bright 86-year old lady at lunch. She had heard I have sleep apnea and told me that she is only able to sleep about four hours each night and when she gets up in the morning she feels exhausted. She goes to her PCP regularly and he keeps telling her, "Four hours of sleep is all you can expect at your age and it is enough." I referred her directly to a sleep lab. . . .

Hope they don't shorten her life:

http://timesofindia.indiatimes.com/Heal ... 650257.cms
http://www.dailymail.co.uk/health/artic ... heart.html
http://www.telegraph.co.uk/news/newstop ... -life.html

I'm still waiting for that to get debunked.

jnk wrote:

rooster wrote: . . . bright 86-year old lady at lunch. She had heard I have sleep apnea and told me that she is only able to sleep about four hours each night and when she gets up in the morning she feels exhausted. She goes to her PCP regularly and he keeps telling her, "Four hours of sleep is all you can expect at your age and it is enough." I referred her directly to a sleep lab. . . .

Hope they don't shorten her life:

http://timesofindia.indiatimes.com/Heal ... 650257.cms
http://www.dailymail.co.uk/health/artic ... heart.html
http://www.telegraph.co.uk/news/newstop ... -life.html

I'm still waiting for that to get debunked.

Let me guess these countries have national health care plans?

Bone headness comes to mind concerning the logic of the reseach meaning. Why not prevent the condition that causes many heart attacks and strokes. I just hear our president on national TV for the third day in a row. Things are not well. Health care cost WILL NOT be reduced through prevention but through the reduction of care to those in need of it especially if advanced in age.

Gale Hawkins wrote:

jnk wrote:

rooster wrote: . . . bright 86-year old lady at lunch. She had heard I have sleep apnea and told me that she is only able to sleep about four hours each night and when she gets up in the morning she feels exhausted. She goes to her PCP regularly and he keeps telling her, "Four hours of sleep is all you can expect at your age and it is enough." I referred her directly to a sleep lab. . . .

Hope they don't shorten her life:

http://timesofindia.indiatimes.com/Heal ... 650257.cms
http://www.dailymail.co.uk/health/artic ... heart.html
http://www.telegraph.co.uk/news/newstop ... -life.html

I'm still waiting for that to get debunked.

Let me guess these countries have national health care plans?

Bone headness comes to mind concerning the logic of the reseach meaning. Why not prevent the condition that causes many heart attacks and strokes. I just hear our president on national TV for the third day in a row. Things are not well. Health care cost WILL NOT be reduced through prevention but through the reduction of care to those in need of it especially if advanced in age.

I NEED that study to get debunked, because it goes through my head every time I want to fuss at anyone over 65 who isn't using his or her machine. My gut tells me it is stupid, but I want some kind of proof. It bothers me enough to hijack rooster's thread like this, so someone out there please help me!!!

jnk I before I saw this did not know this school of thought was out there. You might start with Google to debulk.

jnk wrote:

I'm still waiting for that to get debunked.

JNK,

I have already debunked this one (at least to my own satisfaction) in another thread, viewtopic.php?f=1&t=37850&p=330508&hili ... er#p330508

See what you think:

rooster wrote:

packitin wrote:To answer my own question, it may be that if the body gets to beyond 65, it somehow compensates. I know this was posted a couple of months ago, but remember that this study was done in Israel and is very surprising to me still. I wonder if it still stands. Or maybe I'm just desperate for some good news, since every time a study comes out, it's always bad news for those of us with sleep apnea.
Jay

http://www.thaindian.com/newsportal/ind ... 03332.html

Packitin,

That's a good point you bring up about that study. You did not ask, but I will give you my take on it anyway.

Let's think about those two groups in the study. One group has moderate sleep apnea and one group does not have sleep apnea. All individuals in both groups are over age 65.

Now let's discuss the group with sleep apnea. Now as we know from reading this forum and other sources, many, if not most, of the individuals in the group with sleep apnea did not get it after the age of 65; they had sleep apnea for years or decades before the age of 65. How do you think the mortality of this 'apnea group' compares to the 'non-apnea' group before either group turns 65? I think the apnea group had a much higher mortality before age 65 than the non-apnea group.

Now back to the study, I would say the apnea group, having lost many members to death, is now made up of indiduals who are more fit to survive. So the study is comparing a group which has already culled many weaker individuals to a non-apnea group which has not culled so many members. Thus you end up with the surprising results.

What does this mean for us? The easy answer you already know is "Use CPAP every sleeping minute."

Regards,

rooster wrote:

jnk wrote:

I'm still waiting for that to get debunked.

JNK,

I have already debunked this one (at least to my own satisfaction) in another thread, viewtopic.php?f=1&t=37850&p=330508&hili ... er#p330508

See what you think:

rooster wrote:

packitin wrote:To answer my own question, it may be that if the body gets to beyond 65, it somehow compensates. I know this was posted a couple of months ago, but remember that this study was done in Israel and is very surprising to me still. I wonder if it still stands. Or maybe I'm just desperate for some good news, since every time a study comes out, it's always bad news for those of us with sleep apnea.
Jay

http://www.thaindian.com/newsportal/ind ... 03332.html

Packitin,

That's a good point you bring up about that study. You did not ask, but I will give you my take on it anyway.

Let's think about those two groups in the study. One group has moderate sleep apnea and one group does not have sleep apnea. All individuals in both groups are over age 65.

Now let's discuss the group with sleep apnea. Now as we know from reading this forum and other sources, many, if not most, of the individuals in the group with sleep apnea did not get it after the age of 65; they had sleep apnea for years or decades before the age of 65. How do you think the mortality of this 'apnea group' compares to the 'non-apnea' group before either group turns 65? I think the apnea group had a much higher mortality before age 65 than the non-apnea group.

Now back to the study, I would say the apnea group, having lost many members to death, is now made up of indiduals who are more fit to survive. So the study is comparing a group which has already culled many weaker individuals to a non-apnea group which has not culled so many members. Thus you end up with the surprising results.

What does this mean for us? The easy answer you already know is "Use CPAP every sleeping minute."

Regards,

The reasoning has merit, though a bit Darwinian.

I guess it's the thought that oxygen-deprived organs are more likely to survive the oxygen deprivation of a heart attack, allowing more time for intervention, that keeps getting stuck in my head. It seems it should be easy to prove that CPAP extends lives in any age group, if it is so. And it HAS to be so, doesn't it?

Sometimes I get caught in a loop like that. Sorry.

Meanwhile, I will support your harrassment of 86-year-old ladies.

jnk wrote:.........

Meanwhile, I will support your harrassment of 86-year-old ladies.

Without conceding any point of my argument, I would beg for a consideration of quality of life not just length of life. The sweet lady, by her own assessment, is living a poor quality of life.

rooster wrote:Study shows how sleep apnea may cause stroke

WASHINGTON (Reuters) - A dangerous type of snoring known as sleep apnea can cause stroke by decreasing blood flow, raising blood pressure and harming the brain's ability to modulate these changes, researchers reported on Tuesday.

Not only that, but the increased vibration caused by snoring, may displace plaques from blood vessels including the carotid artery. These plaques may lodge in blood vessels within the brain and cause a stroke.

"Snoring-associated vibration energy transmission from the upper airway to the carotid artery has been hypothesized as a potential atherosclerotic
plaque initiating/rupturing event that may provide a pathogenic mechanism linking snoring and embolic stroke."


http://jap.physiology.org/cgi/reprint/103/5/1622.pdf