Obstruktive Schlaf-Apnoe und Schlaganfall^[]

Zusammenfassung

Mehr als die Hälfte der hospitalisierten Schlaganfall-Patienten leiden an schlafbezogenen Atmungsstörungen und 5 − 10 % der erstdiagnostizierten Patienten mit obstruktiver Schlaf-Apnoe (OSA) haben einen Schlaganfall in der Anamnese. Epidemiologische Studien haben gezeigt, dass die unbehandelte OSA ein unabhängiger Risikofaktor für einen Schlaganfall ist. Pathophysiologisch spielen wahrscheinlich mehrere Faktoren eine Rolle (OSA-assoziierte arterielle Hypertonie, Atherosklerose, Vorhofflimmern, paradoxe Embolie durch ein offenes Foramen ovale und gestörte zerebrovaskuläre Reaktivität). Eine koexistente OSA verschlechtert den funktionellen Outcome und das Überleben von Patienten mit Schlaganfall. Andererseits hat die CPAP-Therapie günstige Effekte auf das Neuauftreten und die Rezidivrate von Schlaganfällen bei OSA und auch auf den klinischen Verlauf von Patienten, die einen Schlaganfall erlitten haben.

Abstract

More than half of the patients hospitalised with stroke suffer from sleep-disordered breathing and 5 − 10 % of patients with newly diagnosed obstructive sleep apnea (OSA) have a history of stroke. Epidemiological studies have shown that untreated OSA is an independent risk factor for stroke. Various pathophysiological mechanisms may contribute to the development of stroke in these patients (i. e., OSA-associated arterial hypertension, atherosclerosis, atrial fibrillation, paradoxical embolism through a patent foramen ovale and disturbed cerebrovascular reactivity). Co-existent OSA has a negative impact on both the recovery of neurological functions and the survival of patients with stroke. On the other hand, CPAP therapy has beneficial effects on the incidence and recurrence of stroke in OSA and also on the clinical outcome of those patients who are victims of stroke.

Serienherausgeber: H. W. Duchna, Wangen
W. Randerath, Solingen

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