Snoring and Stroke: The Hidden Connection

Here’s another reason to pay attention when your partner complains that you’re snoring or gasping for air at night: sleep apnea – repeated episodes of stopped or slowed breathing during sleep – and stroke go together in more ways than you think.

Leslie Ingold, RN, MSN, a regional stroke coordinator at OSF HealthCare, says sleep apnea decreases blood flow to the brain, which can cause a stroke. Conversely, she says people who have suffered a stroke can experience sleep apnea, typically in the first day or two.

Ingold also says people with obstructive sleep apnea (collapse of the upper airway) are twice as likely to have a hole in their heart known as a patent foramen ovale (PFO). PFOs can increase your stroke risk.

“One of the tests we do when [stroke] patients come to the hospital is an echocardiogram of the heart. A PFO is what we’re looking for. It’s that hole in your heart that doesn’t close properly when you’re a child,” Ingold says. “It’s actually what they look for in sports physicals when kids are in school. Listening for that extra ‘lub-dub’ in the heartbeat. Sometimes it’s not caught. We’re finding people in their 60s and 70s that have the hole. We can go in and get that closed.”

What to watch for

Some things to watch for that might prompt you to see a health care provider about sleep apnea:

• Snoring. Ingold says watch for loud snoring or a pattern of snoring when you didn’t used to.

“When you can hear it through the wall,” she quips.

• Waking up and gasping for air
  
• Morning headaches
  
• Excessive sleepiness, difficulty concentrating and irritability throughout the day. For kids, watch for hyperactivity.
  
• Increased blood pressure

For stroke signs, experts want you to remember the acronym BEFAST. If there are irregularities in balance, eyes, face, arms or speech, it’s time to call 9-1-1.

Nighttime strokes

Ingold says one in four strokes happens in the early morning when you’re likely asleep. Those so-called “wake up strokes” can make things tricky.

Medicine like tenecteplase (TNK) must be given at the hospital within 4.5 hours of the onset of symptoms. If you suffer a stroke while you’re sleeping, there’s not a good way to know when symptoms started. So, health care providers must go by the last time you were well, which would be when you went to sleep.

“There are some other things that can be done,” Ingold says, if TNK is not an option. “If there’s a clot, we can take care of those up to 24 hours [since symptom onset.] We can see if there are early signs of brain damage and get you on the road to those kinds of procedures if you qualify.”

But a big takeaway message: if you have stroke symptoms like a severe or unexpected headache, don’t sleep it off. See a health care provider.