Elderly people with severe sleep apnea, E in which breathing repeatedly stops and starts during sleep, face more than twice the risk of stroke than people with mild sleep apnea or none, Spanish researchers report. Previous studies on stroke and sleep apnea have focused on middle-aged people, but it's older people who have the greatest incidence of stroke, according to study lead researcher Dr. Roberto Munoz, a neurologist at the Hospital de Navarra, in Pamplona, Spain.

The Study

In the study, Munoz's team analyzed 394 people, ages 70 to 100. Over a six-year period, 20 of the study participants had strokes. Patients with severe sleep apnea had a 25-fold increased risk of stroke than patients with no apnea, mild apnea or moderate apnea, Munoz's team found.

What To Do

"Sleep apnea is two to three times more common in the elderly compared to middle-aged people," Munoz said. "However, typical symptoms of sleep apnea, such as loud snoring or excessive daytime sleepiness, are less prevalent in the elderly compared to middle-aged people. We should be aware of these symptoms, and specifically look for the presence of repetitive breathing pauses in our patients and relatives."

Apnea treatment should be started in patients who have a high rate of apnea episodes, particularly in patients with other cardiovascular risk factors, the researchers suggested.

"Snoring is the most important warning sign for sleep apnea," Munoz said. "People who live alone, which is common in the elderly, should be aware that excessive daytime sleepiness is another key risk factor."

One expert agrees that treating sleep apnea is important in reducing the risk of stroke.

Dr. Thomas M. Hemmen, an assistant clinical professor of neurology at the University of California, San Diego, noted that treatment for sleep apnea is becoming standard in reducing the risk of both heart attack and stroke. "People with sleep apnea are much more aggressively treated with respiratory aids during the night," he said.

Sleep apnea is typically treated with behavioral changes, such as losing weight or sleeping on your side. There are also oral devices that help keep the airway open.

New Help for Common Sleep Problem

The FDA-approved Pillar Palatal Implant for sleep apnea—the sleep disorder that causes people to stop breathing intermittently—requires outpatient surgery, during which three pieces of polyester string are sewn into the soft palate. This causes the tissue to stiffen, which reduces sleep apnea and snoring. The procedure is comparable to somnoplasty, in which microwaves directed at the back of the throat stiffen tissue. Either operation is simpler and less painful than the standard surgery to remove excess throat and soft palate tissue.

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