Sleep-disordered breathing as a risk factor for cerebrovascular disease: a case-control study in patients with transient ischemic attacks

Nigel McArdle, Renata L Riha, Marjorie Vennelle, Emma L Coleman, Martin S Dennis, Charles P Warlow, Neil J Douglas

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND AND PURPOSE: The evidence that obstructive sleep apnea/hypopnea (OSAH) is a risk factor for ischemic cerebrovascular disease is inconclusive. We explored this relationship in transient ischemic attack (TIA) patients because they are less likely than stroke patients to have OSAH as a consequence of cerebrovascular disease.

METHODS: We performed a case-control study among 86 patients with TIA from a hospital neurovascular clinic, matched for age (+/-5 years) and sex with controls from the referring local family practice registers.

RESULTS: Forty-nine of the 86 matched pairs were male and the body mass index was similar among cases and controls. The primary outcome measure, the apnea/hypopnea index [AHI=number of (apneas+hypopneas)/h slept, measured during overnight polysomnography and scored blind to case-control status], was the same for cases and controls (21/hour). However, the median number of 4% desaturations during sleep was slightly greater in the cases (12/hour) than controls (6/hour, P=0.04). There were the expected associations between TIA and higher fibrinogen levels (TIA 3.3, control 3.0 g/L, P=0.01), previous myocardial infarction (TIA 22, control 6%, P=0.007), a history of ever smoking (TIA 71, control 54%, P=0.01), hypertension (TIA 51, control 21%, P=0.001), and raised cholesterol (TIA 27, control 10%, P=0.01), with a weak trend for diabetes mellitus (TIA 10, control 6%, P=0.4).

CONCLUSIONS: OSAH does not appear to be strongly associated with TIAs.

Original languageEnglish
Pages (from-to)2916-21
Number of pages6
JournalStroke; a journal of cerebral circulation
Issue number12
Publication statusPublished - Dec 2003

Keywords / Materials (for Non-textual outputs)

  • Aged
  • Body Mass Index
  • Case-Control Studies
  • Cerebrovascular Disorders
  • Comorbidity
  • Female
  • Fibrinogen
  • Great Britain
  • Humans
  • Ischemic Attack, Transient
  • Male
  • Polysomnography
  • Risk Factors
  • Sleep Apnea Syndromes


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