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Q J Med 2000; 93: 647-654
© 2000 Association of Physicians

Review

Snoring, sleep apnoea and stroke: chicken or scrambled egg?

J.A. Harbison and G.J. Gibson

From the Department of Respiratory Medicine, Freeman Hospital, Newcastle upon Tyne, UK


   Introduction
 
Several case-control studies1–6 have suggested that snoring is one of the factors associated with an increased risk of stroke. Snoring is, of course, a cardinal feature of the obstructive sleep apnoea syndrome (OSA), leading some authors1,4,7 to conclude that any risk associated with snoring is likely attributable to the minority of subjects in the snoring population who have OSA. Whether snoring and/or OSA independently increase the risk of stroke remains contentious, mainly because of potential confounding of the association by well-established risk factors such as obesity and hypertension.

Other studies have shown a high prevalence of sleep apnoea shortly after stroke.8–12 To what extent is this a consequence of the stroke, and how much does it reflect pre-existing sleep apnoea? Furthermore, in view of the dearth of information in healthy subjects of the appropriate age, are the post-stroke findings as abnormal as they seem?

Snoring and the risk of stroke
In case-control studies of the risk . . . [Full Text of this Article]


   Obstructive sleep apnoea and the risk of stroke
 

   Stroke and sleep
 

   Sleep apnoea following stroke
 

   Course and significance of sleep apnoea post-stroke
 

   Type of apnoea/hypopnoea
 

   Conclusions
 

   Acknowledgments
 

   Notes
 

   References
 

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