]Sleep-Disordered Breathing and Stroke

Obstructive sleep apnea (OSA) and stroke are common and serious multifactorial health problems that share many risk factors. Cohort studies have shown that some adult populations with severe OSA are at risk for stroke.'' Any given case usually has many modifiable risk factors'' for stroke that improve after OSA is successfully treated. To date, no double-blinded, randomized, controlled, treatment-versusnontreatment trial has proved that OSA can cause stroke, and ethical constraints may prohibit such studies. Clinical trials are needed to assess the effectiveness of OSA treatment in improving stroke outcome. If treatment is proven to reduce morbidity and mortality significantly in a cost-effective manner, routine screening and more aggressive treatment options might become the standard of care for this patient population.