Sleep Apnea and Stroke: A Risk Factor or an Association?

This article explores the relationship between obstructive sleep apnea syndrome and stroke by critically reviewing the current literature. First, epidemiologic studies are analyzed with respect to issues regarding the strength of the association, and the consistency of the association using different study designs and different populations. Next, the biologic plausibility of the relationship is explored by reviewing studies that examine the pathophysiology of sleep apnea and stroke. Subsequently, studies exploring the therapeutic impact of obstructive sleep apnea syndrome on stroke and cardiovascular risk are reviewed. Finally, public health implications are discussed.