Obstructive sleep apnea, also known as OSA, is a potentially deadly sleeping disorder. Studies examine how this sleep disorder, which causes a cessation of breathing during sleep, affects those with other conditions. Late in 2018 researchers focused their attention on stroke victims who suffer with OSA. This large study found that beginning OSA treatment as soon as possible after either a stroke or a mini-stroke drastically improves speech impairment as well as other neurological symptoms. Patients began to notice improvement in walking as well as other physical functions.
While it may not seem like a problem to stop breathing for a few seconds at night, the fact is that it’s actually a significant problem. While one occurrence is unlikely to cause any damage, sleep apnea patients experience several, sometimes hundreds, of these episodes each night. Every time the body stops breathing at night, oxygen levels decrease. This causes a rise in blood pressure and adversely affects the heart, brain, and so much more.
This, in turn, has a negative impact on the sufferer by impairing their concentration, memory, reaction time, and causing daytime drowsiness. When these aspects of brain function are affected, the sleep apnea patient becomes a danger to themselves and others. Sleep apnea has been one of the leading causes behind automobile accidents and workplace accidents across the nation.
In addition to the short term risks, OSA poses a danger to long term health by negatively impacting nearly every system in the body in some way. This damage can ultimately lead to a much higher risk of heart attack or stroke. Thankfully, with treatment, much of this damage is reversible.
The National Stroke Guidelines recommend sleep apnea testing. However, there wasn’t really any research that supported this recommendation. The recent study took a look at individuals who’ve suffered a stroke or a transient ischemic attack, also known as a mini stroke or TIA, who also have sleep apnea. These patients were provided with the standard CPAP (Continuous Positive Airway Pressure) therapy commonly used for individuals with OSA.
It turned out that the CPAP therapy proved to have greater benefits than an FDA approved stroke treatment drug according to Regenstrief Institute and Roudebush VA Medical Center research scientist Dawn Bravata, M.D., who led the study.
Stroke is the fifth leading cause of death here in the United States. The National Institute of Neurological Disorders and Stroke says more than 780,000 strokes occur each year in the U.S. alone. The study, comparing the treatment and the relationship between stroke and sleep apnea, is published in the Journal of the American Heart Association under the title “Diagnosing and Treating Sleep Apnea in Patients with Acute Cerebrovascular Disease.”
TIAs have symptoms similar to a stroke but usually only last a few minutes. It’s also rare for TIAs to cause permanent damage. However, a TIA may be an early warning sign for future stroke victims. About twenty-five percent of people who’ve suffered a TIA will have a stroke. Of that quarter, around half of the strokes will occur within the twelve months following the mini-stroke.
According to News Medical, sleep apnea is common among those who’ve suffered from a stroke or TIA. About two thirds of stroke victims suffer from the sleep disorder. Unfortunately, few stroke patientsundergo diagnosis and treatment for OSA.
The study followed stroke victims for up to one year after their event. Of these individuals, two thirds of the 252 total participants were able to use CPAP effectively.
“Preliminary data suggests the sooner you treat sleep apnea in stroke patients with CPAP, the more potent the effect of that treatment,” said Dr. Bravata. “Usually diagnosing sleep apnea is an outpatient service, but we need to make sleep testing acutely available to stroke and TIA patients in the hospital as part of their work-up, just as we do brain imaging, lab testing, and cardiac monitoring as part of the initial stroke/TIA evaluation.”
“This will require changes in sleep medicine services by healthcare systems as they allow care for stroke patients; but the benefits of acute sleep apnea management are now clear,” Dr. Bravata said.
The patients who participated in the study were from five different hospitals across two states. They were randomly placed in either a control group without sleep apnea treatment or one of two intervention groups that included sleep apnea diagnosis and treatment. As mentioned above, Dr. Bravata feels strongly that the results of the study show a need for sleep apnea diagnosis and treatment as soon as possible after the stroke event. Early treatment provides the best results.
While CPAP therapy is generally safe and effective, it also has a high non-compliance rate. This is because many patients feel as though the CPAP machine is uncomfortable, loud, and impairs their sleep or the sleep of their partner. Thankfully, recent advances in dental medicine have prompted the creation of an oral appliance for the treatment of sleep apnea.
For patients who don’t tolerate CPAP therapy or those who prefer to seek alternate methods, the answer may be found in a customizable dental device. These oral appliances have been shown to effectively treat mild to moderate sleep apnea in many patients. Currently, it’s only available through dental professionals who have been through training for sleep medicine, like Mark Levy DDS.
If you or a loved one are struggling with CPAP therapy or sleep apnea, reach out to our offices to learn more about an alternative to CPAP therapy.