ABSTRACT
B18 Sleep Apnea and Stroke Antonio Culebras The Sleep Center, Community General Hospital, and Department of Neurology, Upstate Medical University, Syracuse, New York, U.S.A.
INTRODUCTION
Scarcely 30 years ago, sleep apnea was not found in textbooks of medicine. Today sleep apnea is a household term that conjures popular ideas of suffocation, stroke, and death in sleep. Sudden death or injury as a direct result of sleep apnea is a very rare occurrence and yet sleep apnea is a very common disorder. Some studies indicate that as many as 2% of women and 4% of men (1) may be afflicted with the disorder, intensely enough to warrant medical attention. The increasing recognition of sleep apnea has become a promoter of sleep medicine and has significantly contributed to the dramatic expansion of the discipline of sleep in all its aspects, including development of sleep centers and laboratories, corporate increase, accreditation of hundreds of centers, certification of thousands of individuals, and financial growth. Although sleep is a function of the brain, specialists in breathing have felt compelled to become involved in all medical aspects of the disorder, from clinical diagnosis and treatment to basic research. In many instances, sleep apnea is part of the spectrum of a series of body alterations that requires a holistic approach to better serve patients. Sleep apnea is frequently linked to obesity, a worldwide epidemic (2), and both are linked to cardiovascular and cerebrovascular risk. Obesity is a predisposing factor for obstructive sleep apnea. Other predisposing factors are structural abnormalities of the oropharynx, maxillomandibular malformations, tonsillar hypertrophy, and palatal height. Some endocrinologic disorders, including acromegaly and hypothyroidism, and some congenital anomalies, such as Down’s syndrome, predispose to sleep apnea. Smoking, alcohol consumption, and sedative ingestion worsen the condition.
