#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Obstructive sleep apnea and cerebral blood flow


Authors: P. Šiarnik;  M. Jurík;  P. Karapin;  K. Klobučníková;  B. Kollár;  P. Turčáni
Authors‘ workplace: I. neurologická klinika LF UK a UN Bratislava
Published in: Cesk Slov Neurol N 2019; 82(3): 268-273
Category: Review Article
doi: https://doi.org/10.14735/amcsnn2019268

Overview

Sleep-disordered breathing is a frequent disorder that affects approximately one quarter of the common population of adults. Numerous studies suggest a tight link between sleep apnea and ischemic stroke as well as between sleep apnea and cognitive impairment. Cerebral hypoperfusion and hemodynamic changes during apneic events could be a key mechanism involved in both processes. In a current paper, we present an overview of dia­gnostic methods that could be potentially used for a blood flow monitoring in obstructive sleep apnea patients. We also report our experience with the use of US tagged near-infrared spectroscopy during overnight polysomnography which was not previously reported in the literature.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

cerebral blood flow – Cerebral ischemia – transcranial Doppler ultrasonography – ultrasound tagged NIRS


Sources

1. Yaggi HK, Concato J, Kernan WN et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353(19): 2034–2041. doi: 2010.1056/NEJMoa043104.

2. Siarnik P, Kollar B, Carnicka Z et al. Association of sleep disordered breathing with wake-up acute ischemic stroke: a full polysomnographic study. J Clin Sleep Med 2016; 12(4): 549–554. doi: 510.5664/jcsm.5688.

3. Munoz R, Duran-Cantolla J, Martinez-Vila E et al. Severe sleep apnea and risk of ischemic stroke in the elderly. Stroke 2006; 37(9): 2317–2321. doi: 10.1161/01.STR.0000236560.15735.0f.

4. Redline S, Yenokyan G, Gottlieb DJ et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 2010; 182(2): 269–277. doi: 10.1164/rccm.200911-1746OC.

5. Urbano F, Roux F, Schindler J et al. Impaired cerebral autoregulation in obstructive sleep apnea. J Appl Physiol (1985) 2008; 105(6): 1852–1857. doi: 10.1152/japplphysiol.90900.2008.

6. Balfors EM, Franklin KA. Impairment of cerebral perfusion during obstructive sleep apneas. Am J Res­pir Crit Care Med 1994; 150(6 Pt 1): 1587–1591. doi: 10.1164/ajrccm.150.6.7952619.

7. Klingelhöfer J, Hajak G, Sander D et al. Assessment of intracranial hemodynamics in sleep apnea syndrome. Stroke 1992; 23(10): 1427–1433.

8. Daulatzai MA. Cerebral hypoperfusion and glucose hypometabolism: key pathophysiological modulators promote neurodegeneration, cognitive impairment, and Alzheimer‘s disease. J Neurosci Res 2017; 95(4): 943–972. doi: 910.1002/jnr.23777.

9. Kielb SA, Ancoli-Israel S, Rebok GW et al. Cognition in obstructive sleep apnea-hypopnea syndrome (OSAS): current clinical knowledge and the impact of treatment. Neuromolecular Med 2012; 14(3): 180–193. doi: 110.1007/s12017-12012-18182-12011.

10. Kiratli PO, Demir AU, Volkan-Salanci B et al. Cerebral blood flow and cognitive function in obstructive sleep apnea syndrome. Hell J Nucl Med 2010; 13(2): 138–143.

11. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien: American Academy of Sleep Medicine 2014: 383.

12. Shiomi T, Guilleminault C, Stoohs R et al. Leftward shift of the interventricular septum and pulsus paradoxus in obstructive sleep apnea syndrome. Chest 1991; 100(4): 894–902.

13. Somers VK, White DP, Amin R et al. Sleep apnea and cardiovascular disease: an American Heart Association/ American College of Cardiology Foundation scientific statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). J Am Coll Cardiol 2008; 52(8): 686–717. doi: 10.1016/ j.jacc.2008.05.002.

14. Tkáčová R. Spánkové apnoe a ochorenia kardiovaskulárného systému. Praha: Galén 2006: 194.

15. Hedner J, Ejnell H, Sellgren J et al. Is high and fluctuating muscle nerve sympathetic activity in the sleep apnoea syndrome of pathogenetic importance for the development of hypertension? J Hypertens 1988; 6 (Suppl 4):S529–S531.

16. Franklin KA. Cerebral haemodynamics in obstructive sleep apnoea and Cheyne-Stokes respiration. Sleep Med Rev 2002; 6(6): 429–441.

17. Somers VK, Javaheri S. Cardiovascular effects of sleep-related breathing disorders. In: Kryger MH (ed). Principles and practice of sleep medicine. Saunders: Elsevier Inc. 2005: 1180–1191.

18. Hill CM, Hogan AM, Onugha N et al. Increased cerebral blood flow velocity in children with mild sleep-disordered breathing: a possible association with abnormal neuropsychological function. Pediatrics 2006; 118(4): e1100–e1108.

19. Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982; 57(6): 769–774. doi: 710.3171/jns.1982.3157.3176.0769.

20. Klingelhöfer J, Hajak G, Sander D et al. Assessment of intracranial hemodynamics in sleep apnea syndrome. Stroke 1992; 23(10): 1427–1433.

21. Balfors EM, Franklin KA. Impairment of cerebral perfusion during obstructive sleep apneas. Am J Respir Crit Care Med 1994; 150 (6 Pt 1): 1587–1591. doi: 1510.1164/ajrccm.1150.1586.7952619.

22. Hajak G, Klingelhöfer J, Schulz-Varszegi M et al. Sleep apnea syndrome and cerebral hemodynamics. Chest 1996; 110(3): 670–679.

23. Rieke K, Poceta JS, Mitler MM et al. Continuous blood flow velocity measurements in obstructive sleep apnea syndrome. J Neuroimag 1992; 2(4): 202–207. doi: 10.1016/j.permed.2012.02.021.

24. Narkiewicz K, Somers VK. Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand 2003; 177(3): 385–390. doi: 10.1046/j.1365-201X.2003.01091.x.

25. Dincer HE, O‘Neill W. Deleterious effects of sleep-disordered breathing on the heart and vascular system. Respiration 2006; 73(1): 124–130. doi: 10.1159/000089814.

26. Somers VK, Dyken ME, Mark AL et al. Parasympathetic hyperresponsiveness and bradyarrhythmias during apnoea in hypertension. Clin Auton Res 1992; 2(3): 171–176.

27. Prilipko O, Huynh N, Thomason ME et al. An fMRI study of cerebrovascular reactivity and perfusion in obstructive sleep apnea patients before and after CPAP treatment. Sleep Med 2014; 15(8): 892–898. doi: 810.1016/j.sleep.2014.1004.1004.

28. Faraci FM, Heistad DD. Regulation of the cerebral circulation: role of endothelium and potassium channels. Physiol Rev 1998; 78(1): 53–97. doi: 10.1152/physrev.1998.1178.1151.1153.

29. Jelic S, Padeletti M, Kawut SM et al. Inflammation, oxidative stress, and repair capacity of the vascular endothelium in obstructive sleep apnea. Circulation 2008; 117(17): 2270–2278. doi: 2210.1161/CIRCULATIONAHA.2107.741512.

30. Jiménez Caballero PE, Coloma Navarro R, Ayo Martín O et al. Cerebral hemodynamic changes in obstructive sleep apnea syndrome after continuous positive airway pressure treatment. Sleep Breath 2013; 17(3): 1103–1108. doi: 1110.1007/s11325-11013-10810-y.

31. Coloma Navarro R, Jiménez Caballero PE, Vega G et al. Cerebral hemodynamics is altered in patients with sleep apnea/hypopnea syndrome. Springerplus 2016; 5: 51. doi: 10.1186/s40064-40016-41691-x.

32. Morgan BJ, Reichmuth KJ, Peppard PE et al. Effects of sleep-disordered breathing on cerebrovascular regulation: a population-based study. Am J Respir Crit Care Med 2010; 182(11): 1445–1452. doi: 1410.1164/rccm.201002-200313OC.

33. Pizza F, Biallas M, Wolf M et al. Nocturnal cerebral hemodynamics in snorers and in patients with obstructive sleep apnea: a near-infrared spectroscopy study. Sleep 2010; 33(2): 205–210.

34. Hayakawa T, Terashima M, Kayukawa Y et al. Changes in cerebral oxygenation and hemodynamics during obstructive sleep apneas. Chest 1996; 109(4): 916–921.

35. Valipour A, McGown AD, Makker H et al. Some factors affecting cerebral tissue saturation during obstructive sleep apnoea. Eur Respir J 2002; 20(2): 444–450.

36. McGown AD, Makker H, Elwell C et al. Measurement of changes in cytochrome oxidase redox state during obstructive sleep apnea using near-infrared spectro­scopy. Sleep 2003; 26(6): 710–716.

37. Meyer JS, Sakai F, Karacan I et al. Sleep apnea, narcolepsy, and dreaming: regional cerebral hemodynamics. Ann Neurol 1980; 7(5): 479–485. doi: 410.1002/ana.410070515.

38. Fischer AQ, Chaudhary BA, Taormina MA et al. Intra­cranial hemodynamics in sleep apnea. Chest 1992; 102(5): 1402–1406.

39. Shiota S, Inoue Y, Takekawa H et al. Effect of continuous positive airway pressure on regional cerebral blood flow during wakefulness in obstructive sleep apnea. Sleep Breath 2014; 18(2): 289–295. doi: 210.1007/s11325-11013-10881-11329.

40. Ficker JH, Feistel H, Möller C et al. [Changes in regional CNS perfusion in obstructive sleep apnea syndrome: initial SPECT studies with injected nocturnal 99mTc-HMPAO]. Pneumologie 1997; 51(9): 926–930.

41. O‘Donoghue FJ, Wellard RM, Rochford PD et al. Magnetic resonance spectroscopy and neurocognitive dysfunction in obstructive sleep apnea before and after CPAP treatment. Sleep 2012; 35(1): 41–48. doi: 10.5665/sleep.1582.

42. Innes CR, Kelly PT, Hlavac M et al. Decreased regional cerebral perfusion in moderate-severe obstructive sleep apnoea during wakefulness. Sleep 2015; 38(5): 699–706. doi: 610.5665/sleep.4658.

43. Murphy BD, Chen X, Lee TY. Serial changes in CT cerebral blood volume and flow after 4 hours of middle cerebral occlusion in an animal model of embolic cerebral ischemia. AJNR Am J Neuroradiol 2007; 28(4): 743–749.

44. Yadav SK, Kumar R, Macey PM et al. Regional cerebral blood flow alterations in obstructive sleep apnea. Neurosci Lett 2013; 555: 159–164. doi: 10.1016/j.neulet.2013.1009.1033.

45. C-FLOW Specifications. [online]. Available from URL:http: //www.ornim.com/wp-content/uploads/2016/03/ornim_medical-c_flow-cflow-MGG1087A_specs.pdf.

46. UTLight Technology. [online]. Available from URL: http: //www.ornim.com/wp-content/uploads/2015/11/UTL_MGG1020C_1cm.pdf.

47. Schytz HW, Guo S, Jensen LT et al. A new technology for detecting cerebral blood flow: a comparative study of ultrasound tagged NIRS and 133Xe-SPECT. Neurocrit Care 2012; 17(1): 139–145. doi: 110.1007/s12028-12012-19720-12022.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 3

2019 Issue 3

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#