Research Topic

Sleep and Cerebrovascular Disease: Strategies to Promote Brain Health

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Sleep-disordered breathing (SDB) and sleep-wake disturbances (SWD) are highly prevalent in stroke patients and it is estimated that up to 70% of stroke patients may have SDB. SDB is also a novel cardiovascular and cerebrovascular risk factor that presents unique opportunities to understand and reduce ...

Sleep-disordered breathing (SDB) and sleep-wake disturbances (SWD) are highly prevalent in stroke patients and it is estimated that up to 70% of stroke patients may have SDB. SDB is also a novel cardiovascular and cerebrovascular risk factor that presents unique opportunities to understand and reduce seemingly intractable stroke risk. In addition, recent studies suggest that other SWD such as short and long sleep durations, as well as hypersomnia, insomnia and restless legs syndrome (RLS)/periodic limb movements in sleep (PLMS) may increase the stroke risk. It is unclear the mechanisms by which sleep disordered breathing and sleep wake disturbances increase stroke risk. However, some studies suggest that a variety of autonomic, chemical, inflammatory mechanisms and vascular risk factors (hypertension, obesity, and diabetes mellitus) may at the culprit of sleep and stroke risk. Untreated SDB exacerbates post-stroke prognosis, as it may also influence rehabilitation efforts and functional outcomes such as cognitive function following a stroke. Few studies found that SWD may impair neuroplasticity processes and functional recovery from stroke. Conversely treatment of SDB may reduce the risk of stroke and may yield greater post-stroke prognosis. Unfortunately, in there is limited awareness, knowledge, and screening opportunities for SDB. Increasing awareness and improving screening strategies for SDB may alleviate stroke risk burden and improve stroke outcomes.
This Research Topic is intended to attract manuscripts that highlight the link between sleep disorders stroke and vascular risk factors. The aim is to help elucidate the populations, mechanisms and sleep factors that lead to an increase stroke risk and cerebrovascular burden. In particular, we need studies that address the basic science and the epidemiology, clinical characteristics, pathophysiology, diagnosis, genetics and treatment of sleep disorders in stroke populations and other at risk populations. Particularly differences by minority (African Americans, Hispanic/Latinos among others), age groups and sex may provide insights into vulnerable populations. Observational and experimental studies on preventative treatment options are welcomed, as well as studies on positive airway pressure (CPAP) therapy, and alternative therapies such as oral appliances and positional therapies.
Notably, there is a paucity of tested psychosocial and biological mechanistic pathways to explain the stroke risk associated to impaired sleep. Answering this question has the potential to inform our understandings about discrepancies in SDB-related morbidity and SDB-related comorbid medical conditions, the CPAP adherence, and SDB-related quality of life that potentially modifies the stroke risk.


Keywords: obstructive sleep apnea, central sleep apnea, stroke, transient ischemic attack, hypersomnia, insomnia, neuroplasticity, restless legs syndrome, positive airway pressure, stimulants, vascular cognitive impairment, dementia


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