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Obstructive sleep apnea (OSA) is a prevalent disease and has been increasingly recognized as an independent risk factor for hypertension, diabetes, cardiovascular disease, and stroke. Stroke is a frequent disease, a second leading cause of death worldwide which generates high healthcare costs. Recent studies suggest that sleep apnea is common after stroke with the prevalence of 50-94%. OSA is emerging as one of the important risk factors for stroke.
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2. Ancoli-Israel S, Kripke DF, Klauber MR, et al. Sleep- disordered breathing in community dwelling elderly. Sleep 1991;14:486-95.
3. Dyken ME, Somers VK, Yamada T, et al. Investigating the relationship between stroke and obstructive sleep apnea. Stroke 1996;27:401-7.
4. Bassetti C, Aldrich M, Chervin R, et al. Sleep apnea in patients with transient ischemic attack and stroke. Neurology 1996;47:1167-73.
5. Bassetti C, Aldrich MS. Sleep apnea in acute cerebrovas- cular diseases: final report on 128 patients. Sleep 1999; 22:217-23.
6. Parra O, Arboix A, Bechich S, et al. Time course of sleep- related breathing disorders in first-ever stroke or transient ischemic attack. Am J Respir Crit Care Med 2000;161:375-80.
7. Wessendorf TE, Teschler H, Wang YM, et al. Sleep disor- dered breathing among patients with first-ever stroke. J Neurol 2000;247:41-7.
8. Turkington PM, Bamford J, Wanklyn P, et al. Prevalence and predictors of upper airway obstruction in the first 24 hours after acute stroke. Stroke 2002;33:2037-42.
9. Iranzo A, Santamaria J, Berenguer J, et al. Prevalence and clinical importance of sleep apnea in the first night after cerebral infarction. Neurology 2002;58:911-6.
10. Hui DS, Choy DK, Wong LK. Prevalence of sleep dis- ordered breathing and continuous positive airway pressure compliance: results in Chinese patients with first-ever ischemic stroke. Chest 2002;122:852-60.
11. Harbison J, Ford GA, James OF, et al. Sleep disordered breathing following acute stroke. QJM 2002;95:741-7.
12. Szucs A, Vitrai J, Janszky J, et al. Pathological sleep apnoea frequency remains permanent in ischaemic stroke and it is transient in haemorrhagic stroke. Eur Neurol 2002;47:15-9.
13. Bassetti CL, Milanova M, Gugger M. Sleep-disordered breathing and acute ischemic stroke: diagnosis, risk factors, treatment, evolution, and long-term clinical outcome. Stroke 2006;37:967-72.
14. Rola R, Wierzbicka A, Wichniak A, et al. Sleep related breathing disorders in patients with ischemic stroke and transient ischemic attacks: respiratory and clinical correlations. J Physiol Pharmacol 2007;58:575-82.
15. Yan-Fang S, Yu-Ping W. Sleep-disordered breathing: Impact on functional outcome of ischemic stroke patients. Sleep Med 2009;10:717-9.
16. Broadley SA, Jr gensen L, Cheek A, et al. Early investigation and treatment of obstructive sleep apnoea after acute stroke. J Clin Neurosci 2007;14:328-33.
17. Johnson KG, Johnson DC. Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J Clin Sleep Med 2010;6:131-7.
18. Dávalos A, Cendra E, Teruel J, et al. Deteriorating ischemic stroke: risk factors and prognosis. Neurology 1990;40:1865-9.
19. Toni D, Fiorelli M, Gentile M, et al. Progressing neu- rological deficit secondary to acute ischemic stroke. A study on predictability, pathogenesis, and prognosis. Arch Neurol 1995;52:670-5.
20. Partinen M, Palomaki H. Snoring and cerebral infarction.Lancet 1985; ii:1325-6.
21. Palomaki H. Snoring and the risk of ischemic brain infarction. Stroke 1991; 22:1021-5.
22. Spriggs DA, French JM, Murdy JM, et al. Snoring increases the risk of stroke and adversely affects progno- sis. Q J Med 1992;83:555-62.
23. Smirne S, Palazzi S, Zucconi M, et al. Habitual snoring as a risk factor for acute vascular disease. Eur Resp J 1993; 6:1357-61.
24. Jennum P, Schultz-Larsen K, Davidsen M, et al. Snoring and risk of stroke and ischaemic heart disease in a 70 year old population. A 6-year follow-up study. Int J Epidemiol 1994;23:1159-64.
25. Neau JP, Meurice JC, Paquereau J, et al. Habitual snoring as a risk factor for brain infarction. Acta Neurologica Scandinavica 1995;92:63-8.
26. Koskenvuo M, Kaprio J, Telakivi T, et al. Snoring as a risk factor for ischaemic heart disease and stroke in men. Br Med J 1987;294:16-9.
27. Marin JM, Carrizo SJ, Vicente E, et al. Long-term cardio- vascular outcomes in men with obstructive sleep apnoea- hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046-53.
28. Yaggi HK, Concato J, Kernan WN, et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005;353:2034-41.
29. Young T, Finn L, Peppard PE, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008;31:1071-8.
30. Munoz R, Duran-Cantolla J, Martinez-Vila E, et al. Severe sleep apnea and risk of ischemic stroke in the elderly. Stroke 2006;37:2317-21.
31. Redline S, Yenokyan G, Gottlieb DJ, et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 2010;182:269-77.
32. Nieto FJ, Young TB, Lind BK, et al. Association of sleep- disordered breathing, sleep apnea and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000;283:1829-36.
33. Chung KF, Chan KN, Lam SP, et al. Previously unrecog- nized obstructive sleep apnea in Chinese subjects with essential hypertension. Thorax 1999;177:391-400.
34. Young T, Peppard P, Palta M, et al: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med 1997;157:1746-52.
35. Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea as a risk factor for hypertension: population study. BMJ 2000;320:479-82.
36. Worson CT, Naughton MT, Barter CE, etal. Theprevalence of obstructive sleep apnea in hypertensives. Am J Respir Crit Care Med 1998;157:111-5.
37. Logan AG, Perlikwski SM, Mente A, et al. High preva- lence of unrecognized sleep apnea in drug-resistant hypertension. J Hypertens 2001;19: 2271-7.
38. Peppard PE, Young T, Palta M, et al. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342:1378-84.
39. Gislason T, Almqvist M. Somatic diseases and sleep com- plaints: an epidemiological study of 3,201 Swedish men. Acta Med Scand 1987;221:475-81.
40. Mehra R, Benjamin EJ, Shahar E, et al. Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. Am J Respir Crit Care Med 2006;173:910-6.
41. Netzer N, Werner P, Jochums I, et al. Blood flow of the middle cerebral artery with sleep-disordered breathing: correlation with obstructive hypopneas. Stroke 1998; 29:87-93.
42. Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA 2003;290:1906-14.
43. Fischer AQ, Chaudhary BA, Taormina MA, et al. Intracranial hemodynamics in sleep apnea. Chest 1992;102:1402-6.
44. Lorenzi-Filho G, Drager LF. Obstructive sleep apnea and atherosclerosis: a new paradigm. Am J Respir Crit Care Med 2007;175:1219-21.
45. Savransky V, Jun J, Li J, et al. Dyslipidemia and athero- sclerosis induced by chronic intermittent hypoxia are attenuated by deficiency of stearoyl coenzyme A desaturase. Circ Res 2008;103:1173-80.
46. Amatoury J, Howitt L, Wheatley JR, et al. Snoring-related energy transmission to the carotid artery in rabbits. J Appl Physiol 2006;100:1547-53
47. Beelke M, Angeli S, Del Sette M, et al. Prevalence of patent foramen ovale in subjects with obstructive sleep apnea: a transcranial Doppler ultrasound study. Sleep Med 2003;4:219-23.
48. Bassetti C, Aldrich MS, Quint D. Sleep-disordered breathing in patients with acute supra- and infratentorial strokes. A prospective study of 39 patients. Stroke 1997; 28:1765-72.
49. Dávalos A, Cendra E, Teruel J, et al. Deteriorating ischemic stroke: risk factors and prognosis. Neurology 1990; 40:1865-9.
50. Toni D, Fiorelli M, Gentile M, et al. Progressing neu- rological deficit secondary to acute ischemic stroke. A study on predictability, pathogenesis, and prognosis. Arch Neurol 1995;52:670-5.
51. Bradley TD, Floras JS. Obstructive sleep apnea and its cardiovascular consequences. Lancet 2009;373:82-93.
52. Good DC, Henkle JQ, Gelber D, et al. Sleep-disordered breathing and poor functional outcome after stroke. Stroke 1996;27:252-9.
53. Parra O, Arboix A, Montserrat JM, et al. Sleep-related breathing disorders: impact on mortality of cerebrovascular disease. Eur Respir J 2004;24:267-72.
54. Sahlin C, Sandberg O, Gustafson Y, et al. Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Arch Intern Med 2008; 168:297-301.
55. Sandberg O, Franklin KA, Bucht G, et al. Nasal continuous positive airway pressure in stroke patients with sleep apnoea: a randomized treatment study. Eur Respir J 2001;18:630-4.
56. Kaneko Y, Hajek VE, Zivanovic V, et al. Relationship of sleep apnea to functional capacity and length of hospital- ization following stroke. Sleep 2003;26:293-7.
57. Brown DL, Lisabeth LD, Zupancic MJ, et al. High prevalence of supine sleep in ischemic stroke patients. Stroke 2008;39:2511-4.
58. Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, et al. Ambulatory blood pressure after therapeutic and subther- apeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002;359:204-10.
59. Martínez-García MA, Galiano-Blancart R, Román- Sánchez P, et al. Continuous positive airway pressure treatment in sleep apnea prevents new vascular events after ischemic stroke. Chest 2005;128:2123-9.
60. Martínez-García MA, Soler-Cataluña JJ, Ejarque- Martínez L, et al. Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow-up study. Am J Respir Crit Care Med 2009;180:36-41.
61. Chin K, Ohi M, Kita H, et al. Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1996;153:1972-6.
62. Chin K, Kita H, Noguchi T, et al. Improvement of factor VII clotting activity following long-term NCPAP treat- ment in obstructive sleep apnea syndrome. QJM 1998; 91:627-33.
63. Arnardottir ES, Mackiewicz M, Gislason T, et al. Molecular signatures of obstructive sleep apnea in adults: a review and perspective. Sleep 2009;32:447-70.
64. Drager LF, Bortolotto LA, Figueiredo AC, et al. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 2007;176:706-12.
65. Oztura I, Kaynak D, Kaynak HC. Nocturia in sleep- disordered breathing. Sleep Med 2006;7:362-7.
66. Fitzgerald MP, Mulligan M, Parthasarathy S. Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment. Am J Obstet Gynecol 2006;194:1399-403.