Syndrome d'apnées du sommeil et accidents vasculaires cérébraux

The prevalence of obstructive sleep apnea syndrome (OSAS) following stroke or transient ischemic attack is high. There is a likely causative link between OSAS and stroke. The potential mechanisms linking OSAS and stroke are numerous. They include arterial hypertension, modifications of cerebral hemodynamic, cardiac arrhythmia, coagulation disorders, atherosclerosis. OSAS in stroke patients is associated with increased morbidity, mortality and poor functional outcome. The effectiveness of nasal continuous positive airway pressure (nCPAP) on the prevention of cardio-vascular accidents has been clearly evidenced. In stroke patients, nCPAP is associated with an improved well being and a decreased nocturnal blood pressure. On the other hand it does not improve cognitive functions, daily activities and delirium.