In order to prevent stroke, there needs to be significant improvements in the diagnosis and screening of sleep apnea, suggests new guidelines on stroke care released today at the Canadian Stroke Congress.

Obstructive sleep apnea is the most common type of sleep apnea, where the flow of air pauses or decreases during sleep because the airway has narrowed or blocked. It is a disorder that not only increases the chance of having a stroke, but it can also be a serious complication after the person suffers a strokeb, the Canadian Best Practice Recommendations for Stroke Care indicates.

Previous research has found that approximately 50% of women aged 20 to 70 years experience obstructive sleep apnea, with 20% having moderate, and 6% having severe symptoms.

Even after adjusting for certain variables, including high blood pressure and diabetes, sleep apnea was found to increase the general population’s chance of having a stroke.

Although serious sleep apnea affects only 4% of males and 2% of females at absolute minimum, explains Dr. Brian Murray, an associate professor of neurology and sleep medicine at the University of Toronto, over 10% of people are struggling with clinically significant forms of the disorder.

Dr. Murray says:

“There are ways to prevent sleep apnea from occurring. Keep your body weight low as obesity is a major contributor to sleep apnea; avoid medications and substances that relax the airways and cause snoring, such as sedatives and alcohol; and sleeping on your side can minimize sleep disordered breathing.”

Some symptoms of the condition, include:

  • pauses in breathing while asleep
  • significant snoring
  • tiredness in the daytime even after sufficient sleep at night

Dr. Murray advises individuals to see a health professional for diagnosis and treatment if any of these signs are present.

Research has shown that the majority of people with obstructive sleep apnea remain undiagnosed, therefore going untreated which can reduce work productivity.

With at least 60% of stroke victims developing obstructive sleep apnea, the new recommendations calls for more screening of stroke patients who report tiredness, snoring, or fragmented sleep. However, Dr. Murray points out, stroke patients usually don’t show signs of daytime fatigue.

If individuals do not treat sleep apnea, they put themselves at an increased risk of a second stroke. Therefore, screening for sleep apnea is critical. Previous research has shown that worse rehabilitation results are often seen in stroke patients with sleep apnea.

The best practices report “higher rates of mortality and other complications in patients with stroke and untreated obstructive sleep apnea.”

Ian Joiner, director of stroke for the Heart and Stroke Foundation, explains:

“This innovative Canadian research continues to show that there is more to learn about rehabilitation and recovery following stroke. Reflecting these advances in tools such as the Best Practices Recommendations for Stroke Care will help improve outcomes for Canadians.”

Although the new guidelines are the 4th update to the Canadian Best Practice Recommendations for Stroke Care, this is the first time a section on sleep apnea was incorporated.

First released in 2006 to better the care for Canadians suffering from stroke and future stroke patients, the recommendations are modernized every two years.

“The new recommendations take stroke care a step further,” adds Dr. Michael Hill, Canadian Stroke Congress Co-Chair. “Stroke care is not only about giving the best possible treatment to patients. It is also about preventing new and recurrent strokes.”

Written by Sarah Glynn