Several large epidemiological studies have shown a strong association between OSA and the development of cerebrovascular disease and there is growing evidence to support this finding. These include Transient Ischaemic attacks and stroke. There is increased morbidity and mortality rates in these patients. Conversely patients with Strokes are at increased risk of developing obstructive and central sleep apnoea. Early recognition and treatment of Obstructive sleep apnoea has been shown to prevent cerebrovascular events.
Aim To assess the prevalence of cerebrovascular events in a cohort of patients diagnosed with obstructive sleep apnoea in Ashford.
Methods 100 patients with a confirmed diagnosis of OSA were randomly selected to enter the study. Detailed data, about their demographics, co morbidities as well as sleep, were collected. Obstructive Sleep apnoea was classified as mild, moderate and severe based on AHI (mild <15/h, moderate 15–30/h and severe >30/h). TIA was defined as a neurological deficit which resolved completely within 24 h and was not associated with any changes on CT/MRI. Stroke was classified according to the territory involved and accompanied by CT/MRI changes. Cholesterol was checked in all the patients and associated Diabetes mellitus was noted as well.
Results In this cohort, more patients had severe sleep apnoea (62%). There was an increased incidence of cerebrovascular morbidities in the severe group as compared with the mild and moderate groups. 20% of all patients had hypercholesterolaemia (45% in the severe group), 10% of all patients had Transient Ischaemic Attack (80% in the severe group), 2% had Stroke (100% in the severe group) and 16% had Diabetes mellitus.
Conclusions Our study showed significant cerebrovascular comorbidities in patients with obstructive sleep apnoea. There is evidence to suggest that effective treatment of the sleep apnoea improves cerebrovascular outcomes. The fact that most of our patients with cerebrovascular comorbidity had TIA rather than strokes suggest that there is a window of opportunity to prevent further events by effective treatment. This certainly reduces the physical, social and financial burden incurred by strokes. We suggest that all patients with TIA should be screened for Obstructive Sleep apnoea and treated appropriately.
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