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Sleep apnea prevalent in patients with asymptomatic carotid stenosis

Sleep apnea was prevalent in patients with asymptomatic extracranial carotid stenosis and linked with arteriosclerotic disease severity, according to study results.

Between 2007 and 2012 Jens Ehrhardt, MSc, of Jena University Hospital in Germany, and colleagues performed polysomnography on 96 patients (mean age, 65.9 years) diagnosed with asymptomatic carotid stenosis to determine the severity of sleep apnea for different degrees of carotid stenosis. Seventy-five patients had severe disease vs. 21 patients with mild to moderate stenosis.

Sleep apnea was present in 68.8% of the patients; obstructive sleep apnea (OSA) was determined in 41.7% of the cohort and central sleep apnea (CSA) was prevalent in 27.1%.

The prevalence of sleep apnea in patients with severe carotid stenosis was greater than that of patients with mild or moderate disease (76% vs. 42.4%; P ≤.01).

Hypertension (adjusted OR = 4.11; 95% CI, 1.02-16.47) and sleep apnea (aOR = 3.81; 95% CI, 1.12-13.1) were the highest independent predictors of carotid stenosis severity in a multivariate logistic regression analysis.

Focusing on the two types of sleep apnea, the researchers indicated CSA (aOR = 12.5; 95% CI, 1.47-106.02) was an independent predictor of arterial hypertension while OSA was not.

The researchers wrote that the best therapy for patients with OSA and CSA is various forms of nocturnal positive-pressure ventilation; more research, however, is needed on the effects on CSA.

“In OSA, positive-pressure ventilation has been found to prevent progression of arteriosclerosis, to improve endothelial dysfunction, and to reverse early arteriosclerotic changes indicated by carotid intima-media thickening,” the researchers wrote. “Because these protective effects on arteriosclerotic disease have predominantly been shown in OSA, it remains unclear if positive-pressure ventilation has comparable effects in CSA.” –by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.