Is Obstructive Sleep Apnea a Risk Factor of SubclinicalWhite Matter Damages?

J Korean Neurol Assoc > Volume 26(4); 2008 > Article

Journal of the Korean Neurological Association 2008;26(4): 323-332.

폐쇄수면무호흡증후군은 무증상 뇌백질병변의 위험인자인가?

윤지영, 김지현a 최경규 박기덕 김용재 이향운

이화여자대학교 의과대학 신경과학교실, 단국대학교 의과대학 신경과학교실a

Is Obstructive Sleep Apnea a Risk Factor of SubclinicalWhite Matter Damages?

Jiyoung Yun

Department of Neurology, School of Medicine, Ewha Womans University and Ewha Medical Research institute, Seoul, Department of Neurology, Dankook University College of Medicinea, Cheonan, Korea

Abstract

Background: Obstructive sleep apnea (OSA) has been reported to increase risk of ischemic stroke. This study was performed to investigate the prevalence and relationship of subclinical white matter damages (SD) in patients with OSA.
Methods: All subjects (n = 54) had brain MRI and nocturnal polysomnogram (PSG). SD are defined by nonsymptomatic lacunar infarcts > 3 mm or periventricular white matter changes (PVWC). We analyzed the difference between OSA patients with and without SD (SD and non-SD groups), and also with and without PVWC. Using apnea-hypopnea index (AHI), we classified OSA into mild (5≤AHI≤15) and moderate to severe (AHI>15).
Results: SD group (n = 31) showed significantly increased apnea-hypopnea index (AHI), apnea index (AI) and oxygen desaturation index (ODI) compared to non-SD (n = 23). Among the 37 patients without lacunar infarctions, 14 showed PVWC while the other 23 did not have any lesions. Compared to non-SD group, SD group showed increased AHI and ODI, and decreased lowest SaO2 (p < 0.05). Similarly, AHI and ODI were higher and the lowest SaO2 was lower in patients with PVWC than without PVWC (p < 0.05). Moderate to severe OSA group showed more frequent subclinical or periventricular white matter changes than mild group (p < 0.05).
Conclusions: Severity of OSA showed a positive correlation with the occurrence of subclinical white matter damages. OSA may cause subclinical white matter damages.KeyWords:Obstructive sleep apnea, Subclinical white matter damage, Oxygen desaturation

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