Sleep apnea and acute stroke deterioration

Kristian Barlinn, Andrei Alexandrov

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Sleep-disordered breathing of variable degrees is associated with an increased risk of neurological deterioration within the first 72 hours after stroke onset. The pathogenic link between sleep apnea and acute deterioration in ischemic stroke patients is now a subject of clinical investigations. Vasomotor reactivity and intracranial blood flow steal in response to changing vasodilatory stimuli like carbon dioxide play a pivotal role in clinical deterioration with reversed Robin Hood syndrome. A mechanical ventilatory correction in acute stroke patients might have a beneficial effect on sleep apnea and brain perfusion. This is a novel therapeutic target and the missing link in the pathogenesis of early neurological deterioration and stroke recurrence. This chapter reviews the present knowledge of sleep-disordered breathing and acute neurological deterioration in stroke patients, highlighting clinical studies addressing this issue, and discusses future directions regarding noninvasive ventilatory correction to reverse cerebral blood flow (CBF) steal or even to augment blood flow in these patients. We cover sleep-disordered breathing and its acute assessment for non-sleep-disorder readers, ultrasound and hemodynamics for all readers, and specific steps that stroke specialists can currently make to identify these patients and possibly treat them early.

Original languageEnglish (US)
Title of host publicationSleep, Stroke, and Cardiovascular Disease
PublisherCambridge University Press
Pages104-114
Number of pages11
ISBN (Electronic)9781139061056
ISBN (Print)9781107016415
DOIs
StatePublished - Jan 1 2010

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Sleep Apnea Syndromes
Stroke
Cerebrovascular Circulation
Songbirds
Carbon Dioxide
Perfusion
Hemodynamics
Recurrence
Brain

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Barlinn, K., & Alexandrov, A. (2010). Sleep apnea and acute stroke deterioration. In Sleep, Stroke, and Cardiovascular Disease (pp. 104-114). Cambridge University Press. https://doi.org/10.1017/CBO9781139061056.011

Sleep apnea and acute stroke deterioration. / Barlinn, Kristian; Alexandrov, Andrei.

Sleep, Stroke, and Cardiovascular Disease. Cambridge University Press, 2010. p. 104-114.

Research output: Chapter in Book/Report/Conference proceedingChapter

Barlinn, K & Alexandrov, A 2010, Sleep apnea and acute stroke deterioration. in Sleep, Stroke, and Cardiovascular Disease. Cambridge University Press, pp. 104-114. https://doi.org/10.1017/CBO9781139061056.011
Barlinn K, Alexandrov A. Sleep apnea and acute stroke deterioration. In Sleep, Stroke, and Cardiovascular Disease. Cambridge University Press. 2010. p. 104-114 https://doi.org/10.1017/CBO9781139061056.011
Barlinn, Kristian ; Alexandrov, Andrei. / Sleep apnea and acute stroke deterioration. Sleep, Stroke, and Cardiovascular Disease. Cambridge University Press, 2010. pp. 104-114
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