Sleep apnea in patients with transient ischemic attack and minor stroke: opportunity for risk reduction of recurrent stroke?
OBJECTIVE
Patients with TIA and minor stroke are at high risk for recurrent stroke. Obstructive sleep apnea (OSA) may increase this risk. The objectives of our study were to determine the prevalence and severity of OSA and its clinical presentation in this population.


METHODS
Patients who presented with TIA and minor stroke completed a questionnaire and nocturnal cardiopulmonary monitoring to diagnose OSA and associated nocturnal hypoxia.


RESULTS
Sixty-six patients completed the study; 62% had OSA (respiratory disturbance index > 5). Forty-four percent of these patients had moderate or severe OSA (respiratory disturbance index > 15) that was associated with significant nocturnal hypoxia. Most patients did not have the typical clinical features of OSA, such as obesity and daytime sleepiness.


CONCLUSIONS
Patients who experience TIA and minor stroke have a high prevalence of OSA and associated hypoxia. The atypical clinical presentation of OSA in this patient population may lead to under-recognition and treatment. Further studies are required to determine the impact of treating OSA on the risk of recurrent stroke.
Calgary Stroke Program, Faculty of Medicine, University of Calgary, Alberta, Canada. phanly@ucalgary.ca
Wesley
W
Chan
Shelagh B
SB
Coutts
Patrick
P
Hanly
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002534:Hypoxia, Brain / Q000453:epidemiology / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D017286:Polysomnography; D040242:Risk Reduction Behavior; D055502:Secondary Prevention; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000453:epidemiology; D020521:Stroke / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome