TY - JOUR
T1 - Sleep and Stroke
T2 - New Updates on Epidemiology, Pathophysiology, Assessment, and Treatment
AU - Lau, Hsien Lee
AU - Rundek, Tatjana
AU - Ramos, Alberto Rafael
N1 - Publisher Copyright:
© 2019, Springer Nature Switzerland AG.
PY - 2019/6/15
Y1 - 2019/6/15
N2 - Purpose of Review: This review aims to discuss the most recent data on sleep disorders and stroke, highlighting relevant findings for the practicing neurologist or health providers who encounter patients with sleep disorders and stroke. Recent Findings: Sleep apnea and abnormal sleep duration have the strongest association with stroke risk. Possible mechanisms include non-dipping of blood pressure during sleep, hypoxemia, or reoxygenation leading to sympathetic activation, hypertension, atrial fibrillation, and impaired cerebral hemodynamics. Treatment studies suggest that continuous positive airway pressure (CPAP) for sleep apnea could improve primary prevention of stroke, but data is equivocal for secondary prevention. However, CPAP could improve functional outcomes after stroke. Summary: Sleep disorders present an opportunity to improve stroke risk and functional outcomes. However, new strategies are needed to determine the patients at high-risk who would most likely benefit from targeted care. Novel methods for phenotyping sleep disorders could provide personalized stroke care to improve clinical outcomes and public health strategies.
AB - Purpose of Review: This review aims to discuss the most recent data on sleep disorders and stroke, highlighting relevant findings for the practicing neurologist or health providers who encounter patients with sleep disorders and stroke. Recent Findings: Sleep apnea and abnormal sleep duration have the strongest association with stroke risk. Possible mechanisms include non-dipping of blood pressure during sleep, hypoxemia, or reoxygenation leading to sympathetic activation, hypertension, atrial fibrillation, and impaired cerebral hemodynamics. Treatment studies suggest that continuous positive airway pressure (CPAP) for sleep apnea could improve primary prevention of stroke, but data is equivocal for secondary prevention. However, CPAP could improve functional outcomes after stroke. Summary: Sleep disorders present an opportunity to improve stroke risk and functional outcomes. However, new strategies are needed to determine the patients at high-risk who would most likely benefit from targeted care. Novel methods for phenotyping sleep disorders could provide personalized stroke care to improve clinical outcomes and public health strategies.
KW - Obstructive sleep apnea
KW - Positive airway pressure
KW - Sleep disordered breathing
KW - Stroke
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U2 - 10.1007/s40675-019-00142-1
DO - 10.1007/s40675-019-00142-1
M3 - Review article
AN - SCOPUS:85078815564
VL - 5
SP - 71
EP - 82
JO - Current Sleep Medicine Reports
JF - Current Sleep Medicine Reports
SN - 2198-6401
IS - 2
ER -