Chapter 27 Sleep apnea syndrome and high neurological risk factors

Publisher Summary Obstructive sleep apnea (OSAS) has just as significant an impact on the quality of life, cardiovascular morbidity and mortality, and neurological consequences, as stroke, transient ischemic attack (TIA), seizures, and cognitive disorders. OSAS is characterized by repetitive episodes of the upper airway obstruction that occur during sleep (5-10/h of sleep), usually associated with reduction in blood oxygen saturation. OSAS is the most common organic but still underrecognized disorder. It affects 4%-9% of the middle-aged adults. This chapter discusses the evidence linking sleep apnea syndrome and neurological diseases. Many patients, with neurologic disorders, have coexisting sleep apnea, simply because OSAS is so common. Finally, OSAS may exacerbate the underlying neurologic condition through different mechanisms, as chronic sleep deprivation and recurrent episodes of hypoxemia. OSAS has a significant impact on the quality of life and is associated with several high neurological risk factors. The presence of repetitive sleep apnea and periods of hypoxemia is a potential determinant of the risk factors for neurological disorders, in the same way that high blood pressure is. Because of its incidence, clinical symptoms and its causal or precipitating roles in strokes, nocturnal seizures, cognitive dysfunctions, work, and traffic accidents, OSAS represents a real neurological and furthermore public health problem.