Sleep Disorders As Stroke Risk

Sleep disturbance is one of the most common complaints found in patients who visit doctors. It is estimated that each year 20% -40% of adults have difficulty sleeping and 17% of them in serious trouble.

The prevalence of sleep disorders tend to increase every year, it also fits with the increasing age and various causes. Research shows that sleep disorders increase the incidence of various diseases kardioserebrovaskuler. This is mainly associated with breathing disorders during sleep (sleep disorder breathing).

Impaired breathing during sleep

There are two kinds of breathing disorders during sleep patterns, namely Hypoapnea and apnea. Hypoapnea characterized by the narrowing of the respiratory system, 50% -80% for more than 10 seconds and decreasing oxygen saturation of more than 3%.

While sleep apnea is characterized by the narrowing of the airways more than 80% for more than 10 seconds and oxygen saturation decreased more than 3%.

There are three types of sleep apnea is central sleep apnea, upper airway obstructive apnea and a mixture of both.

Sleep apnea is a breathing disorder that occurs during sleep, which lasted for more than 10 seconds. It is said pathological sleep apnea if patients experienced episodes of apnea at least five times in one hour or 30 episodes of apnea during the night. During this periodic chest and abdominal wall movement is very dominant.

Central apnea is common in the elderly, characterized by intermittent loss in performance due to reduced oxygen saturation of respiration. Central apnea is marked by a cessation of airflow and respiratory effort periodically during sleep, so that movement of the chest and abdominal wall disappeared. It is possible damage to the brain stem or hypercapnia.

Impaired respiratory tract (upper airway obstructive) during sleep characterized by increased respiration during apnea, increased effort chest and abdominal wall muscles with the aim of forcing air in through the obstruction. These problems became worse when entering the REM phase. Respiratory disturbance is characterized by a gasping breath, or snoring during sleep.

Snoring is held 3-6 times a sound and then disappeared and repeated every 20-50 seconds. Apnea attacks when the patient does not snore. Due to hypoxia or hipercapnea, causing more active respiration activated by the formation retikularis and medulla respiration center, with the result that the patient was awake and the reflexes returned to normal respiration.

Both at the central or obstructive apnea, patients are often awakened repeatedly at night, which is sometimes difficult to fall asleep again. These disorders are often characterized by head pain or unpleasant feelings in the morning. In children, congenital disorders are often associated with respiratory tract. In adult airways obstruction septal defect, hypothyroidism, or bradikardi, heart disorders, hypertension, and stroke.

OSA (Obstructive Sleep Apnea) and stroke

Obstructive sleep disorder is one form of a new risk factor for stroke. Recent studies Drager (2007) showed no increased risk of stroke by 2.52 times in patients with sleep apnea. It is also associated with an increased risk of hypertension in patients with OSA.

OSA is often found in patients with stroke who managed to live, as much as 63% of those who survive, having this disorder. More and more evidence has shown the existence of a causal link between sleep apnea and stroke.

Excessive fatigue during the day associated with sleep apnea can affect the results of post-stroke recovery. Excessive daytime fatigue may reduce the ability and motivation to continue running the stroke recovery program. As a result, the exercise to recovery is not performed regularly, inhibition of recovery and the results will be much worse.

How to handle?

Before finding the cause of a sleep disorder diagnosis, should be determined in advance danlamanya type of sleep disturbance (duration of sleep disorder), by knowing the type and duration of sleep disorders. In addition to helping identify the cause also can provide adequate treatment.

Diagnosis of sleep disorders facility established in the Laboratory-Based Treatment Overnight Sleep Study (Polysomnography Complete). The medical team will formulate appropriate management of the action degrees of sleep disturbance, patient selection, overall health status, and patient expectations.