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Both men and women appear to have a greater risk of stroke if they suffer from obstructive sleep apnea, researchers found.

Through up to 14 years of follow-up, stroke risk increased along with the obstructive sleep apnea index to a similar extent in both men and women, according to Suzanne Bertisch, MD, instructor in medicine at Harvard Medical School/Beth Israel Deaconess Medical Center in Brookline, Mass.

The 5-year probability of having a stroke with the least severe obstructive sleep apnea index was 0.4% for women and 0.6% for men, while the probability in the highest quartile of obstructive sleep apnea severity was 1.2% for women and 1.8% for men, she reported at the American Thoracic Society meeting in San Diego.

At 10 years, the probability of having a stroke if you were in the lowest quartile of the sleep apnea index was 0.9% for women and 1% for men, while the probability of having a stroke in the highest quartile of the apnea index was 2.3% in women and 3.1% in men.

All results were adjusted for various confounders, including age, race, education level, smoking status, diabetes, hypertension, and body mass index, she said.

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German researchers have linked sleep apnoea to an increased risk of symptomless but dangerous “silent strokes”. There hasn’t been much research exploring the relationship between sleep apnoea and silent strokes, says researcher Jessica Kepplinger, MD, of Dresden University Stroke Center at the University of Technology in Dresden, Germany.

So, Kepplinger and colleagues studied 56 men and women, aged 44 to 75 years, who’d had a stroke or mini-stroke known as a transient ischemic attack. All were given a screening tool that picks up changes in breathing during sleep. Ninety-one percent periodically stopped breathing while they slept.

Then the men and women underwent brain imaging scans. Just over half had little areas of tissue death in the brain that had occurred in the past without a history of corresponding stroke symptoms – evidence of silent stroke. The more times a person stopped breathing during the night, the greater the likelihood of silent stroke, Kepplinger says.

There was no comparison group, so researchers don’t know how many people of the same ages and health status who don’t have sleep apnoea have had silent strokes.

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Older adults who have sleep apnea and who are excessively sleepy in the daytime may have more than twice the risk of death as people who do not have both conditions, new research published in the journal Sleep suggests.

In a study of 289 adults over age 65 without depression or dementia, the risk of death was not increased for people with sleep apnea without excessive daytime sleepiness or for those who reported only excessive daytime sleepiness without having sleep apnea, the researchers say.

“Excessive daytime sleepiness, when associated with sleep apnea, can significantly increase the risk of death in older adults,” study researcher Nalaka S. Gooneratne, MD, MSc, of the University of Pennsylvania Health System in Philadelphia, says in a news release. “We did not find that being sleepy in and of itself was a risk. Instead, the risk of increased mortality only seemed to occur when sleep apnea was also present.”

In the study, 74% of participants were female. The mean age of participants at the start of the study was 78. About half of participants had significant levels of excessive daytime sleepiness and reported that they felt sleepy or struggled to stay awake during daylight hours at least three to four times per week.

Sleep apnoea testing was performed at night in a sleep lab. Participants in the study were recruited between 1993 and 1998. Survival status was determined by searching the Social Security death index, ending Sept. 1, 2009. The study says 160 people, or 55% of the participants, died during an average follow-up period of 14 years.

Those participants who had both sleep apnea and excessive daytime sleepiness had a risk of death that was more than two times higher than those who did not have the combination of these conditions. The researchers say it’s unclear just why sleep apnea combined with excessive daytime sleepiness may increase the death risk of older adults. Whether treatment reduces the risk of death for these people remains to be tested.

Another new study published this month has warned that people with serious a cases of sleep apnea have 2.5 times more chance of suffering an ischemic stroke. This was confirmed in a study undertaken among 394 subjects aged 70 or more. “After studying the quality of their sleep, we tracked the volunteers over the course of six years. After which, 20 of the study subjects had suffered a stroke”, Roberto Munoz, a physician of the Neurology Service of the Hospital Complex of Navarra. The research was presented at the School of Medicine and the University of Navarra Hospital.

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The fourth annual World Sleep Day held on 18 March  – ‘Sleep Well, Grow Healthy’ – was themed to highlight the importance of sleep for people of all ages. Newborn infants, children, adolescents and adults, both young and old, need quality sleep to maintain a healthy life.

The scale of the problem was highlighted by the recently published Philips Index for Health and Wellbeing report – a massive consumer research study conducted across 23 countries, including the United Arab Emirates and Kingdom of Saudi Arabia, involving more than 31,000 people, revealed that 35 percent of people do not feel they get enough sleep, impacting on both their physical and mental health.

Interestingly, with almost half of those responding citing ‘poor sleeper in general’ as a reason for sleep deprivation – it suggests that many may have just resigned themselves to not ever getting a good night’s sleep.

In reality, there are a number of potential causes for a disturbed night’s sleep. These include sleep disorders such as Obstructive Sleep Apnoea (OSA), which affects approximately 4 percent of the adult population. It’s a disorder characterized by airway collapse (behind the tongue) during sleep, which obstructs breathing. If untreated, it can contribute to the development of high blood pressure, diabetes, heart attacks, and strokes. Snoring should also not be ignored in children, as it may be a symptom of OSA.

To find out more about World Sleep Day 2011, visit www.worldsleepday.org.

(source: extract from a Philips press release)

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