March 15, 2021 2:28 PM

Sleep Apnea Not Associated with Wake-Up Stroke

Stroke onset while asleep does not seem to be the direct link between sleep apnea and stroke.

pillow drawn in blue ink on lined paper with yellow and navy font badge saying "lab note" on bottom right
Credit: Michigan Medicine

Although the connection between obstructive sleep apnea and stroke is well known, a recent study does not show an association between those who had sleep apnea and those whose strokes began while they were sleeping.

“When someone wakes up with stroke symptoms, it’s unclear when the event actually began,” explains first author Sonja Schuetz, M.D., M.S., an assistant professor of neurology at Michigan Medicine. This is known as wake-up stroke, and was reported in 30% of the stroke survivors in the study. “Every minute matters in stroke care, so wake-up strokes complicate treatment. We wanted to explore if there’s a link between wake-up stroke and obstructive sleep apnea.”

Instead of confirming a link, senior author Devin Brown, M.D., M.S., says the team’s work reaffirms its previous findings that wake-up stroke is not associated with sleep-disordered breathing in women, this time failing to find a significant association in either sex.

Researchers analyzed data from 837 participants of the BASIC (Brain Attack Surveillance in Corpus Christi) project in Nueces County, Texas, who had completed a baseline interview responding to whether their ischemic stroke occurred during sleep. Almost one-third of the patients also took home sleep apnea tests after their stroke.

Paper cited: “Wake-up stroke is not associated with obstructive sleep apnea,” Sleep Medicine. DOI: 10.1016/j.sleep.2021.02.010