title: Investigating the relationship between stroke and obstructive sleep apnea.
abstract: OBJECTIVE
  We aimed to prospectively determine whether the incidence of obstructive sleep apnea in patients with recent stroke was significantly different from that of a sex- and age-matched control group with no major medical problems.
  
  
  METHODS
  We prospectively performed overnight polysomnography in 24 patients with a recent stroke (13 men and 11 women; mean age [+/- SD], 64.6 +/- 10.4 years) and 27 subjects without stroke (13 men and 14 women; mean age, 61.6 +/- 8.8 years). Patients with either ischemic or hemorrhagic stroke were entered into this study. Polysomnographic evaluations were performed within approximately 2 to 5 weeks after each patient's stroke.
  
  
  RESULTS
  Obstructive sleep apnea was found in 10 of 13 men with stroke (77%) and in only 3 of 13 male subjects without stroke (23%) (P=.0169). Seven of 11 women with stroke (64%) had obstructive sleep apnea, while only 2 of 14 female subjects without stroke (14%) had obstructive sleep apnea (P=.0168). For men with stroke, the mean apnea/hypopnea index (+/- SE) was 21.5 +/- 4.2 events per hour, while for male subjects without stroke it was 4.8 +/- 1.8 events per hour (P=.0014). For women with stroke the mean apnea/hypopnea index was 31.6 +/- 8.8 events per hour, while for female subjects without stroke it was 2.9 +/- 1.6 events per hour (P=.0024). The 4-year mortality for patients with stroke was 20.8%. All patients with stroke who died had obstructive sleep apnea.
  
  
  CONCLUSIONS
  Patients with stroke have an increased incidence of obstructive sleep apnea compared with normal sex- and age-matched control subjects. Hypoxia and hemodynamic responses to obstructive sleep apnea may have predisposed these patients to stroke.
authors.affiliation: Department of Neurology, Sleep Disorders Center, University of Iowa College of Medicine, Iowa City, 52242, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Dyken
authors.forename: V K
authors.initials: VK
authors.lastname: Somers
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Ren
authors.forename: M B
authors.initials: MB
authors.lastname: Zimmerman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D016022:Case-Control Studies; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000150:complications; D002561:Cerebrovascular Disorders / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000503:physiopathology; D012894:Sleep Stages; D012913:Snoring / Q000150:complications; D015996:Survival Rate