In my previous post, I talked about Obstructive Sleep Apnea (OSA) as a contributing factor or cause of ischemic stroke. It is important to emphasize, however, that not only can OSA increase the risk for stroke, but prior research also has shown that any patient who has had a stroke has a much higher risk of either developing or exacerbating OSA as a consequence of a stroke. Neurological deficits following a stroke often include weakness of the face, tongue, or muscles of respiration.

As a result, OSA can be a major problem for post-stroke patients as a cause of

• excessive fatigue or sleepiness
• decreased cognitive function
• a potential risk for having more future strokes

What does this mean for health care professionals? There is a strong two-way relationship between OSA and stroke, and prevention is key. Most of us in the medical community are now aware of the close relationship between sleep apnea and cardiovascular diseases. OSA is now recognized as the number one known cause of high blood pressure in the United States and is associated with a 3-fold increased risk of heart attack.

More health professionals now need to recognize OSA as a potential trigger for ischemic stroke and to have a high index of suspicion for underlying OSA in patients who have had a stroke, particularly if they have lasting neuromuscular weakness. Health care professionals need to have a strong awareness of this two-way relationship between OSA and stroke, and should integrate OSA screening and evaluation in their clinical practice as part of any cardiovascular disease prevention or management program.