Sleep apnea plays dual role in stroke

Stroke guidelines urge better screening, treatment

2012-10-02

(Press-News.org) Improvements to the diagnosis and screening of sleep apnea are critical to stroke prevention, according to new stroke care guidelines released today at the Canadian Stroke Congress.

Obstructive sleep apnea, a disorder where the flow of air to the brain pauses or decreases during sleep, is both a risk factor for stroke and a complication following stroke, according to the Canadian Best Practice Recommendations for Stroke Care.

Among the general population sleep apnea increases the likelihood of having a stroke, even after controlling for other stroke risk factors, such as high blood pressure and diabetes, researchers say.

At absolute minimum, four per cent of men and two per cent of women have serious sleep apnea, says Dr. Brian Murray, an associate professor of neurology and sleep medicine at the University of Toronto. Dr. Murray adds that clinically significant forms of the disorder affect more than 10 per cent of the population.

"There are ways to prevent sleep apnea from occurring," says Dr. Murray. "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."

Signs of sleep apnea include significant snoring, pauses in breathing during sleep and daytime fatigue despite adequate sleep time. If any of these symptoms are present, says Dr. Murray, you should be evaluated by your doctor to determine next steps.

Obstructive sleep apnea is common after stroke. According to the updated best practice recommendations, at least 60 per cent of stroke patients experience sleep apnea. The new recommendations call for more screening of stroke patients who say they experience snoring, fragmented sleep or fatigue. Although, in many cases with stroke patients, daytime fatigue does not appear as a symptom, says Dr. Murray.

It is crucial for stroke patients to be screened for sleep apnea because untreated sleep apnea increases the chances of a second stroke and small studies have found that stroke patients with sleep apnea tended to have worse rehabilitation outcomes, says Dr. Murray.

The best practices also describe "higher rates of mortality and other complications in patients with stroke and untreated obstructive sleep apnea."

"This innovative Canadian research continues to show that there is more to learn about rehabilitation and recovery following stroke," says Ian Joiner, director of stroke for the Heart and Stroke Foundation. "Reflecting these advances in tools such as the Best Practices Recommendations for Stroke Care will help improve outcomes for Canadians."

The new recommendations are the fourth update to the Canadian Best Practice Recommendations for Stroke Care and this is the first time the recommendations have included a section on sleep apnea. The best practices were first released in 2006 to improve stroke care for Canadians living with stroke and future stroke patients. They are updated every two years.

"The new recommendations take stroke care a step further," says 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."

The Canadian Stroke Congress is a joint initiative of the Canadian Stroke Network, Heart and Stroke Foundation of Canada and the Canadian Stroke Consortium.

### The Canadian Stroke Network, www.canadianstrokenetwork.ca, is a national research network headquartered at the University of Ottawa. It includes scientists, clinicians and health-policy experts committed to reducing the impact of stroke.

The Heart and Stroke Foundation, www.heartandstroke.ca, a volunteer-based health charity, leads in eliminating heart disease and stroke, reducing their impact through the advancement of research and its application, the promotion of healthy living and advocacy. Healthy lives free of heart disease and stroke. Together we will make it happen.

For more information and/or interviews, contact
The CSC 2012 MEDIA OFFICE September 30 to October 2 at 403-218-7868
Cathy Campbell, Canadian Stroke Network, 613-852-2303 (cell)
Holly Roy, Heart and Stroke Foundation, 780-991-2323

Congress information is at www.strokecongress.ca

ELSE PRESS RELEASES FROM THIS DATE:

Smoking clouds the brain after stroke

2012-10-02

A study of stroke patients from Southern Ontario found those who smoke have more difficulty with problem-solving and decision-making than non-smokers. The study, presented today at the Canadian Stroke Congress, tested mental abilities of 76 patients, including 12 smokers, with an average age of 67.5 years, using the Montreal Cognitive Assessment (MoCA) tool. The MoCA exam tests patients with memory and problem solving questions and gives them a score out of 30. Smokers had a median MoCA score two points lower than non-smokers -- 22 out of 30 compared to 24 out of 30. ...

Expand telestroke in all provinces to save lives, reduce disability

2012-10-02

Widespread use of telestroke -- two-way audiovisual linkups between neurologists in stroke centres and emergency rooms in underserved and rural areas -- would save lives, reduce disability and cut health-care costs in all parts of Canada, according to a major national report released today at the Canadian Stroke Congress. However, despite repeated research that shows telestroke delivers quality stroke care to underserviced areas, few stroke patients in Canada are benefiting from this lifesaving service. "The case for telestroke is compelling and the need is urgent," ...

Alzheimer's disease in men linked to low levels of hormone, IGF-1

2012-10-02

Chevy Chase, MD— Low serum levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) are associated with Alzheimer's Disease in men, but not women, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). IGF-1 and IGFBP-3 are involved in longevity and could be beneficial to cognition, especially in Alzheimer's disease where experimental studies have shown that IGF-1 opposes the main pathological processes of Alzheimer's disease. The current study ...

Study uncovers racial disparities in diabetic complications among underinsured

2012-10-02

Chevy Chase, MD— Diabetes is among the ten leading causes of death in both white and African American patients, but the prevalence of diabetic complications are race-specific, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). "This study is one of only a few to assess whether there is a racial difference in the incidence of diabetic complications," said Gang Hu, MD, PhD, of Pennington Biomedical Research Center in Baton Rouge, Louisiana, and lead author of the study. "Our findings suggest ...

New antibiotic cures disease by disarming pathogens, not killing them

2012-10-02

A new type of antibiotic can effectively treat an antibiotic-resistant infection by disarming instead of killing the bacteria that cause it. Researchers report their findings in the October 2 issue of mBio®, the online open-access journal of the American Society for Microbiology. "Traditionally, people have tried to find antibiotics that rapidly kill bacteria. But we found a new class of antibiotics which has no ability to kill Acinetobacter that can still protect, not by killing the bug, but by completely preventing it from turning on host inflammation," says Brad Spellberg ...

Trojan horse drug therapy provides new approach to treating breast cancer

2012-10-02

When Linda Tuttle was diagnosed with breast cancer, she never imagined her experience would inspire her colleagues to design new treatments to tackle the disease. An administrative assistant in the Department of Chemistry at Wake Forest University, Tuttle was more accustomed to talking to faculty and staff about meetings and course loads – not doctors' appointments and treatment plans. But after her 2009 diagnosis, Tuttle's use of tamoxifen, a drug commonly used to treat breast cancer, inspired medicinal chemist Ulrich Bierbach to develop a targeted therapy that delivers ...

Low levels of vitamin D are associated with mortality in older adults

2012-10-02

Chevy Chase, MD—Low levels of vitamin D and high levels of parathyroid hormone are associated with increased mortality in African American and Caucasian older adults, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM). The study also indicates that the potential impact of remediating low vitamin D levels is greater in African Americans than Caucasians because vitamin D insufficiency is more common in African Americans. For the past several years, there has been considerable interest in the ...

New analysis of presidential candidates' health care plans estimates uninsured by 2022

2012-10-02

New York, NY, October, 2, 2012—The number of uninsured individuals is estimated to increase in every state and to 72 million nationwide—with children and low- and middle-income Americans particularly hard hit—under Governor Mitt Romney's plan to repeal the Affordable Care Act and replace it with block grants to states for Medicaid and new tax incentives, according to a new Commonwealth Fund report. While the details of Governor Romney's proposals have not been specified, a set of assumptions was made for the report based on similar proposals advanced in the past. The ...

Low vitamin D levels linked to more severe multiple sclerosis symptoms

2012-10-02

Low blood levels of vitamin D are associated with an increased number of brain lesions and signs of a more active disease state in people with multiple sclerosis (MS), a new study finds, suggesting a potential link between intake of the vitamin and the risk of longer-term disability from the autoimmune disorder. But researchers, led by Ellen M. Mowry, M.D., M.C.R., an assistant professor of neurology at the Johns Hopkins University School of Medicine and principal investigator of a multicenter clinical trial of vitamin D supplementation in MS patients, caution that more ...

Savant Books Announces the Release of David B. Seaburn's New Novel, "Chimney Bluffs"

2012-10-02

When their four-year-old son, Danny, dies suddenly, Mitch and Kate's grief overwhelms them. Conflicted about going on with their lives, Mitch and Kate decide to leap from a cliff at Chimney Bluffs. When the couple is found by park rangers, Clancy and Bobby, Kate is still very much alive. What follows is a poignant and powerful story of three strangers, each facing a tragic loss, who together find friendship and healing. A novel of hope and redemption by David B. Seaburn, author of "Charlie No Face" (Savant 2010). David B. Seaburn is the author of the "Charlie ...

CMD-OPT model enables the discovery of a potent and selective RIPK2 inhibitor as preclinical candidate for the treatment of acute liver injury

Melatonin receptor 1a alleviates sleep fragmentation-aggravated testicular injury in T2DM by suppression of TAB1/TAK1 complex through FGFR1

Single-cell RNA sequencing reveals Shen-Bai-Jie-Du decoction retards colorectal tumorigenesis by regulating the TMEM131–TNF signaling pathway-mediated differentiation of immunosuppressive dendritic ce

Sleep apnea plays dual role in stroke

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: