Why Sleep Apnea Increases Risk of Stroke

Strokes are a scary topic — the fifth leading cause of death in the U.S., they can happen to anyone at anytime with few apparent warning signs. Though sudden, the likelihood of a stroke is increased by the presence of other health conditions. These conditions often have symptoms that can be observed, identified, and treated — and effectively treating the preexisting condition decreases the likelihood of a stroke in the future. One of the health conditions that can lead to a stroke if left untreated is sleep apnea, a common sleep breathing disorder in which the sufferer experiences pauses in or shallow breathing during sleep. As a defense against the restricted oxygen intake, the body temporarily rouses itself from rest so the sufferer can begin breathing again. These breathing cessations and resulting micro-awakenings interrupt our body’s rejuvenating sleep cycle, contributing to poor sleep quality and a multitude of health complications. Common symptoms of sleep apnea include:

• Loud, persistent snoring
• Waking up with a dry mouth
• Waking up at night with a gasping or choking sound
• Morning headaches
• Frequent visits to the bathroom
• Poor concentration
• Consistently feeling tired or lacking energy during the day

Sleep apnea is associated with several serious health conditions, including diabetes, childhood ADHD, and Alzheimer’s. Stroke is particularly prevalent among sleep apnea sufferers, who are both at an increased risk for stroke and more likely to have poor functional outcomes after a stroke. While the nature of a stroke can be scary, sleep apnea sufferers should take heart in the fact that when treatment is adhered to, the risk of suffering a stroke is reduced. Learn more about the link between sleep apnea and stroke, prevention, and treatment options.

What Is a Stroke?

A stroke happens when blood flow to the brain becomes blocked by a blood clot or broken blood vessel, depriving the brain of oxygen. When oxygen stops being supplied to brain cells, the cells begin to die, and abilities controlled by the area of the brain being attacked — such as memory and muscle control — are lost. A stroke’s after effects vary from case to case, depending on the location of the attack and the extent of brain tissue affected. In general, strokes can lead to paralysis, speech and language problems, problems with vision, and memory loss.

What Is the Connection between Sleep Apnea and Stroke?

In 2014, a study by the Journal of Clinical Sleep Medicine was conducted with the goal of determining whether or not obstructive sleep apnea independently increased the risk of all-cause mortality, as well as strokes, cardiovascular disease (CVD), coronary heart disease (CHD), and cancer. Of the 400 initial study participants, 20-year follow-up data was received for 397 individuals. Remaining participants who had a previous stroke or cancer history were removed from the mortality/CVD/CHD/stroke analyses and the cancer analyses, respectively. The findings? In fully adjusted models, moderate to severe obstructive sleep apnea was associated with a significant increased risk of all-cause mortality, stroke, cancer mortality, and incident cancer. According to the National Stroke Association, the nature of sleep apnea makes sufferers more likely to have a stroke. When a patient temporarily stops breathing during sleep, oxygen levels decrease and blood pressure increases, both of which can make a stroke more probable.

How to Prevent a Stroke

Although there are untreatable risk factors that can play into the likelihood of a stroke, including age, gender, race, and family history, there are a number of treatable health modifications you can make to help prevent a stroke’s onset. Maintaining a healthy diet and weight by getting regular exercise, staying away from excessive alcohol and tobacco consumption, and working to manage blood pressure levels will all help reduce risk. As mentioned above, other health conditions can also increase the likelihood of a stroke, including sickle cell disease, diabetes, heart disease, and sleep apnea. Seeking treatment to ease the symptoms of these conditions can decrease stroke risk. For example, for those with diabetes, staying on top of insulin intake will help to reduce high blood glucose levels, which, if left unchecked, can lead to fatty deposits or clots that can block blood flow and cause a stroke. For those suffering from sleep apnea, seeking treatment for the condition will be of the utmost importance for stroke prevention. The condition can be effectively treated by a continuous positive airway pressure (CPAP) machine, an oral appliance, or surgery, depending on the case and the patient.

Sleep Apnea Treatment

CPAP, a bulky, loud machine that uses a face mask to force air into the nasal passages during sleep, is a common treatment for sleep apnea — but up to 50% of people are unwilling or unable to tolerate it, according to the American Academy of Dental Sleep Medicine. Oral appliances, on the other hand, show no significant difference when compared to CPAP in treating mild to severe obstructive sleep apnea — while being comfortable, quiet, non-intrusive and portable. Adherence is the key to treating sleep apnea — if devices are not used every night, patients are still at risk for snoring, sleep deprivation, and, in worst cases, a fatal cessation in breathing. Adhering to treatment will help sleep apnea patients prevent the decreased oxygen levels and increased blood pressure that could lead to a stroke.

Meet the Doctor

Dr. Jeff Rodgers is a board-certified practitioner of dental sleep medicine, providing oral appliances for the treatment of sleep apnea from his practice, Sleep Better Georgia. He is a Diplomate of both the American Board of Dental Sleep Medicine and the American Sleep and Breathing Academy. To learn more about the connection between obstructive sleep apnea and your overall health or to get started with sleep apnea treatment in Atlanta, please contact us today by calling our office or requesting a free consultation.