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Editor's Correspondence
July 10, 2006

Stroke, Obstructive Sleep Apnea, and Disorders of Glucose Metabolism—Reply

Arch Intern Med. 2006;166(13):1419. doi:10.1001/archinte.166.13.1419-a

In reply

There is indeed growing evidence that sleep apnea is associated with impaired glucose tolerance and insulin resistance. There is also some evidence linking sleep apnea to stroke, although prospective population data demonstrating this are not yet available. One recently published prospective study followed subjects referred to the Yale Center for Sleep Medicine, New Haven, Conn, specifically for evaluation of suspected sleep-disordered breathing. Those who indeed had sleep apnea had a significant association of stroke or death after adjustment for other potential risk factors (hazard ratio, 1.97; 95% confidence interval, 1.12-3.48; P = .01).1 Fifty of the outcome events in the sleep apnea group were deaths from any cause; only 22 of the 72 of events were stroke. There were 2 strokes and 14 deaths in the comparison group. The Yale findings were certainly of interest and bolster evidence for the association Arias et al postulate.