Sleep Apnea and Increased Stroke Risk

Sleep apnea is a disorder which affects over 12 million Americans, with the large majority remaining undiagnosed. Yet sleep apnea increases the risk of serious health problems, including stroke. 

For middle aged and older men, the risk is double when they have sleep apnea, illustrating the importance of diagnosing this sleep disorder.

The Link Between Sleep Apnea and Stroke

Sleep apnea is caused by upper airways that collapse during sleep, which cuts off the supply of oxygen to the brain. The more common form of this sleep disorder is obstructive sleep apnea (OSA), where the brain reacts to the reduction in oxygen by prompting the body to wake for air.

These cessations to breathing can happen frequently every night -- even hundreds of times -- but you won’t know it’s happening. Studies show that men with a moderate to severe degree of OSA are three times more likely to suffer a stroke compared to men with a mild degree of the sleep disorder or those without sleep apnea. 

Each time someone has an episode where their breathing stops while they sleep, it places stress on the body to react. Stress hormones are released and blood pressure levels increase. The brain sends out signals to increase the heart rate and blood pressure in order to increase the levels of oxygen being received by the tissues.

Without a diagnosis of OSA, this nightly routine of disturbed sleep, with the body working to keep the airways open, takes its toll. Uncontrolled high blood pressure and the heart condition atrial fibrillation can be the result, two risk factors for strokes.

High blood pressure is also referred to as hypertension, and those with OSA may continue to experience hypertension throughout the day, not just overnight. People who have frequent breathing problems overnight resulting in a lack of oxygen can find their blood pressure remains at an elevated level during the day.

As hypertension is a primary risk factor for strokes, this continued elevation of blood pressure can place someone with undiagnosed sleep apnea at a greater risk.

Recognizing the Symptoms

Strokes are the second leading cause of death in the world. Sleep apnea is not only linked to an increased risk, the disorder also potentially worsens the outcome. The outcome of a stroke depends on the speed of treatment, and if it happens while asleep this hinders the treatment of such a time-sensitive health issue.

Someone who has been diagnosed with high blood pressure can also be further hampered by undiagnosed sleep apnea. Research from 2014 found severe obstructive sleep apnea is linked to hypertension in patients at high risk of cardiovascular disease even when prescribed intensive hypertension drugs. Therefore, OSA may result in medication resistant hypertension.

With so many millions of people living with undiagnosed sleep apnea and treatment of strokes so dependent on speed of response, recognizing the signs of a stroke are crucial. As time is so vital the BE FAST acronym is a good way of remembering the symptoms:

  • B – Balance - sudden loss of balance
  • E – Eyes - loss of vision or problems seeing in one eye or both eyes
  • F – Face looks uneven or has drooped
  • A – Arm drops or is weak
  • S – Speech becomes slurred or difficulty speaking
  • T – Time is critical, call for an ambulance immediately

Treating Obstructive Sleep Apnea

Obstructive sleep apnea left untreated increases the risk of serious health issues including heart disease, high blood pressure and stroke. Once diagnosed there are various treatments available according to the severity of your sleep apnea. Treatments can be very effective at reducing the symptoms of this sleep disorder.

As sleep apnea is a risk factor for strokes, treating sleep apnea can help reduce the risk. This is because treatment helps restore nights of uninterrupted sleep by preventing the blockages which impede breathing. This helps to stabilize oxygen levels, reducing the stress on the body when sleeping which in turn can improve your blood pressure.

Your doctor will most likely discuss lifestyle changes in treating sleep apnea, particularly if you have a mild to moderate severity of the disorder. More exercise and a balanced, nutritional diet will be recommended to help you lose weight, as weight is a major risk factor for sleep apnea. You will also be asked to stop smoking and reduce alcohol consumption as part of any necessary lifestyle changes.

Besides lifestyle changes there are devices which help to keep the airways open as you sleep, preventing the blockages which cause the breathing problems associated with sleep apnea. CPAP is one of the leading treatment methods for moderate to severe OSA, and uses a device to supply pressurized air through a mask worn as you sleep.

Treatment solutions such as CPAP can take a little getting used to for some people. However, perseverance is key as you may soon see a reduction of sleep apnea symptoms. If you are struggling to adhere to the treatment course every night as required you should consult with your doctor who can help you find a better fitting and more comfortable mask.

Adherence to CPAP has been shown to reduce your risk of stroke through reducing the symptoms of sleep apnea and returning you to nights of undisturbed sleep.

Final Thoughts

Sleep apnea, while more prevalent in older men, can affect anyone. The disorder is much higher among people who have suffered strokes. Anyone who has had a stroke should consult their health care provider about a sleep test to screen for sleep apnea. Symptoms of obstructive sleep apnea include:

  • frequent awakening
  • heavy snoring
  • excessive daytime fatigue
  • morning headaches
  • irritability
  • poor concentration

Undiagnosed sleep apnea increases the risk of hypertension and strokes. If you or a loved one has symptoms, talk to a SleepQuest Sleep Care Specialist to learn if you might be at risk for obstructive sleep apnea -- and take first steps toward getting solutions. It’s in the best interest of your good health and long life.