More than 12 million Americans have sleep apnea. Most are undiagnosed or untreated.

Story by: David Steen Martin on June 9, 2020

Snoring loudly is a telltale sign of obstructive sleep apnea and a warning you may face a higher risk of stroke.

Sleep apnea more than doubles the risk of stroke for middle-aged and older men and also increases the stroke risk in middle-aged and older women.

“Sleep apnea is a common but under recognized risk factor for stroke. If you or a loved one has issues with excessive daytime sleepiness, snores loudly or gasps for air during the night, you should be screened by a health care provider for sleep apnea,” said Danny R. Rose Jr., M.D., a neurologist with Norton Neuroscience Institute.

More than 12 million Americans have sleep apnea. Most are undiagnosed or untreated.

Snoring can be a sign your brain is not receiving enough oxygen. If you stop breathing for 10 seconds or longer while you’re sleeping, you may have obstructive sleep apnea.

The more severe your sleep apnea, the greater the risk of stroke. One study found men with moderate to severe sleep apnea were three times as likely to have a stroke as men mild sleep apnea or without sleep apnea. Men with sleep apnea may have a higher risk of stroke because they develop sleep apnea at a younger age.

Sleep apnea also is associated with heart and blood pressure issues, which increase your risk of stroke further. Sleep apnea also increases your risk for heart disease.

During obstructive sleep apnea, the body works hard to open the airway and breathe during these episodes, releasing stress hormones and increasing blood pressure. Over time, this can lead to uncontrolled high blood pressure and a heart condition called atrial fibrillation, or A-fib. High blood pressure, which is also called hypertension, and A-fib are both known risk factors for stroke.

Can you have a stroke in your sleep?

“Strokes during sleep are especially challenging because of the time-sensitive nature of stroke treatment. Our treatment options are often more limited in these situations, as many of these patients have irreversible brain damage before arriving to the hospital,” Dr. Rose said.

Not only is sleep apnea a risk factor for stroke, untreated sleep apnea is associated with poor outcomes after stroke. Stroke is the second-leading cause of death worldwide.

“The rate of sleep apnea is much higher in patients who have experienced a stroke, compared with the general population. Both stroke survivors and health care providers should be aware of this risk, and screening for symptoms of sleep apnea should be considered in any patient who has had a stroke,” Dr. Rose said.

Lifestyle changes like losing weight and quitting smoking can help with milder cases of sleep apnea. Moderate or severe sleep apnea can be treated with a continuous positive airway pressure (CPAP) machine. The CPAP machine keeps your airway passages open. This prevents snoring and apnea.

“Consistent use of CPAP is effective at treating sleep apnea and has been shown to reduce stroke risk factors. Adherence to nightly usage can be challenging for some patients, especially initially as they are acclimating to this change in their sleeping habits. I encourage patients who are having trouble with using their CPAP to speak with their doctor to ensure their equipment fits and functions correctly,” Dr. Rose said.