Stroke as a Consequence of Sleep Apnea: Epidemiology, Pathophysiology and Treatment Strategies

Obstructive sleep apnea syndrome (OSAS) is a common sleep-related breathing disorder that affects up to 7-10% of men and 4-5% of women. It is characterized by repeated events of complete or partial upper airway occlusion occurring during sleep, accompanied by a gradually increasing effort to breathe and terminated by an arousal when the upper airway patency is restored. The most effective treatment option for OSAS is continuous positive airway pressure (CPAP) therapy. There are numerous studies that had linked, without any scientific doubt, OSAS with cardiovascular diseases, morbidity and mortality. In the recent years it became evident as well that acute cerebrovascular events, such as stroke, are also a consequence of obstructive sleep apnea, although the pathophysiology and the mechanisms are not clear as of yet. This mini-review attempts to clarify and to highlight clinically important issues concerning sleep apnea and stroke patients with the aim of their optimal, effective and safe management.