Do All Stroke Patients Need A Sleep Study?

Almost every time I see or hear about a man or woman who suffered from a stroke, the first thing that comes to my mind is, did this person have sleep apnea? We have numerous studies that show that untreated obstructive sleep apnea is an independent risk factor for significantly increasing your risk for stroke (up to 3 times higher). A new study combined 29 different past studies that looked at people with stroke or TIA (transient ischemic attack), and found that 72% of people had obstructive sleep apnea. 


Knowing that up to 57% of men and 35% of women ages 30 to 70, and up to 81% in the elderly (above 65 years) have sleep apnea, this study's findings are not surprising. Untreated sleep apnea has been shown to cause systemic inflammation, thicker blood, slowing of blood flow and many other stroke-promoting factors. Furthermore, patients with sleep apnea are found to have significantly higher rates of brain lacunar infarcts, as well as diminished blood flow and brain neuron density in various critical areas of the brain, including parts that control memory, executive function, breathing and respiration, and autonomic function.


The real question is, does everyone over 60 (or even younger) need a sleep study to prevent strokes and heart attacks?


What's your opinion on this? 

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5 thoughts on “Do All Stroke Patients Need A Sleep Study?

  1. Yes, I think they should.  I'm in shock, as I've just discovered that here in the UK you can only get treatment for OSA if you have more than 10 AHI.  This is disgusting!!  Do you suggest I make waves?  If so, on what evidence can I do it?   I have a personal mission to help people with OSA, due to the fact that I have it and that my Mum died of a heart attack at aged 49 (and she definitely had undiagnosed OSA).  I also think my son has it, but the ENT Surgeon assured me that it's not hereditary.  Load of bull!  How can I convince  him?

  2. Kath, 
    Your frustration is understandable. This is the problem with arbitrary thresholds and Western medicine. In most cases, you have to be on the extreme end of the continuum before qualifying for a clinical diagnosis. Unfortunately, you can't change the system overnight. I suggest gently and tactfully educating your doctors about the potential seriousness of this condition. This is definitely  a hereditary disorder, since you inherit the genes that determine your upper airway anatomy (along with other environmental and dietary factors that can significantly modify your anatomy). 
    Why do you think your son has possible sleep apnea? 

  3. …..because he is exactly like I was as a teenager (he's 14) in that he never wakes up on his own, and has to be literally shook awake.   He never wants to go to bed either (my own personal theory on this is that people with sleep apnoea subconciously know that bed is a place for nightly battles rather than peaceful sleep).  He's fallen asleep in class several times and he suffers in a very big way with brain confusion, short term memory issues, academic problems etc.  He doesn't fit the mould with any of the 'conditions' such as dyslexia, adhd, aspergers, autistic tendencies etc, but he does have a lot of the symptoms of these 'conditions.'  He's very tall and slim, has a massive adams apple and a small receding jaw.  However, he doesn't snore much – although he's a noisy breather.   Maybe I'm wrong, but bearing in mind our family history it's a shame they won't test him just in case! 

  4. Kath,
    Even if he doesn't have official obstructive sleep apnea, he can still have a major sleep-breathing problem. Have you ever considered taking him to an orthodontist or oral surgeon about his small jaw?

  5. I'd not thought of that Dr Parks.  I'll ask my dentist as, coincidentally, he has sleep apnoea himself.  I'm also due to see my own ENT Physician soon, and he was the one who suspected my OSA so, hopefully, he'll listen.  Thanks for your time.  My son said he'd rather have his chin sorted than wear the mask his poor Mum as to LOL!  Thanks for your time – you are such a good support and master of knowledge to us all!  Kath