arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2022-28-3-224-234arthyper-2171Research ArticleОБЗОРREVIEWПатогенетические аспекты взаимосвязи инсульта и нарушений дыхания во снеPathogenetic links between ischemic stroke and sleep-disordered breathinghttps://orcid.org/0000-0002-2857-7982Головкова-КучеряваяМ. С.Golovkova-KucheriavaiaМ. S.

Головкова-Кучерявая Мария Сергеевна—научный сотрудник научно-исследовательского отдела артериальной гипертензии научно-исследовательской лаборатории патогенеза и терапии артериальной гипертензии

ул. Аккуратова, д.2, Санкт-Петербург, 197341

SPIN-код автора: 3910-2329

Mariya S. Golovkova-Kucheriavaia, MD, Researcher, Department for Hypertension, Research Laboratory of Pathogenesis and Therapy of Arterial Hypertension

2 Akkuratova str., St Petersburg, 197341

golovkova.m.s@gmail.comhttps://orcid.org/0000-0002-6484-286XЯнишевскийС. Н.YanishevskiyS. N.

Янишевский Станислав Николаевич — доктор медицинских наук, заведующий научно-исследовательской лабораторией неврологии и нейрореабилитации

Санкт-Петербург

Stanislav N. Yanishevskiy, MD, PhD, DSc, Head, Research Laboratory of Neurology and Neurorehabilitation

St Petersburg

yanishevskiy_sn@almazovcentre.ruhttps://orcid.org/0000-0002-7408-9613БочкаревМ. В.BochkarevМ. V.

Бочкарев Михаил Викторович — кандидат медицинских наук, старший научный сотрудник рабочей группы по сомнологии научно-исследовательского отдела артериальной гипертензии

Санкт-Петербург

Michael V. Bochkarev, MD, PhD, Senior Researcher, Somnology Laboratory, Research Department for Hypertension

St Petersburg

bochkarev_mv@almazovcentre.ruhttps://orcid.org/0000-0001-7585-6012КоростовцеваЛ. С.KorostovtsevaL. S.

Коростовцева Людмила Сергеевна — кандидат медицинских наук, старший научный сотрудник рабочей группы по сомнологии научно-исследовательского отдела артериальной гипертензии

Санкт-Петербург

Lyudmila S. Korostovtseva, MD, PhD, Senior Researcher, Somnology Laboratory, Research Department for Hypertension

St Petersburg

korostovtseva_ls@almazovcentre.ruhttps://orcid.org/0000-0002-3170-0451СвиряевЮ. В.SviryaevYu. V.

Свиряев Юрий Владимирович — доктор медицинских наук, руководитель рабочей группы по сомнологии научноисследовательского отдела артериальной гипертензии

Санкт-Петербург

Yuriy V. Sviryaev, MD, PhD, DSc, Head, Somnology Laboratory, Research Department for Hypertension

St Petersburg

sviryaev_yuv@almazovcentre.ruФГБУ "НМИЦ им. В.А. Алмазова" Минздрава РоссииРоссияAlmazov National Medical Research CentreRussian Federation202202032022283224234Copyright © Головкова-Кучерявая М.С., Янишевский С.Н., Бочкарев М.В., Коростовцева Л.С., Свиряев Ю.В., 20222022Головкова-Кучерявая М.С., Янишевский С.Н., Бочкарев М.В., Коростовцева Л.С., Свиряев Ю.В.Golovkova-Kucheriavaia М.S., Yanishevskiy S.N., Bochkarev М.V., Korostovtseva L.S., Sviryaev Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2171

Обзор посвящен патофизиологическим основам взаимосвязи острого нарушения мозгового кровообращения (ОНМК) и нарушений дыхания во сне. Наряду с основными механизмами реализации патологического действия апноэ во сне на сердечно-сосудистую систему, такими как интермиттирующая гипоксемия, нарушение структуры сна и колебания внутригрудного давления, нарушение симпатико-парасимпатического баланса, оксидативный стресс, рассматриваются генетические факторы и роль глимфатической системы. В обзоре представлены данные о влиянии нарушений дыхания во сне на развитие различных подтипов ОНМК по классификации TOAST и так называемого «инсульта пробуждения», а также потенциальные механизмы, через которые повреждение головного мозга может способствовать возникновению апноэ во сне или усугублению уже имеющихся нарушений.

 

The paper reviews the pathophysiological links between ischemic stroke and sleep-disordered breathing. We discuss well-known mechanisms, such as intermittent hypoxemia, disturbed sleep structure and fluctuations in intrathoracic pressure, autonomic imbalance, oxidative stress, as well as genetic factors and the role of glymphatic system. The impact of sleep-disordered breathing on the development of various subtypes of stroke (according to the TOAST classification) and the so-called “wake-up stroke” is presented.

 

нарушения дыхания во снеобструктивное апноэ во снецентральное апноэ во снеинсультглимфатическая системагенетические факторыsleep-disordered breathingobstructive sleep apneacentral sleep apneastrokeglymphatic systemgenetic polymorphismsРабота выполнена при поддержке гранта Российского научного фонда № 22–25– 20155The work is supported by the grant of the Russian Science Foundation № 22–25– 20155ReferencesJavaheri S, Peker Y, Yaggi HK, Bassetti CLA. Obstructive sleep apnea and stroke: The mechanisms, the randomized trials, and the road ahead. Sleep Med Rev. 2022;61:101568. doi:10.1016/j.smrv.2021.101568Javaheri S, Peker Y, Yaggi HK, Bassetti CLA. Obstructive sleep apnea and stroke: The mechanisms, the randomized trials, and the road ahead. Sleep Med Rev. 2022;61:101568. doi:10.1016/j.smrv.2021.101568Titova OE, Yuan S, Baron JA, Lindberg E, Michaëlsson K, Larsson SC. Sleep-disordered breathing-related symptoms and risk of stroke: cohort study and Mendelian randomization analysis. J Neurol. 2022;269(5):2460–2468. doi:10.1007/s00415-021-10824-yTitova OE, Yuan S, Baron JA, Lindberg E, Michaëlsson K, Larsson SC. Sleep-disordered breathing-related symptoms and risk of stroke: cohort study and Mendelian randomization analysis. J Neurol. 2022;269(5):2460–2468. doi:10.1007/s00415-021-10824-yФонякин А.В., Гераскина Л.А., Максимова М.Ю., Лутохин Г.М. Распространенность и характер нарушений дыхания во сне при ишемическом инсульте. CardioСоматика. 2018;9(2):12–16. doi:10.26442/2221-7185_2018.2.12-16Fonyakin AV, Geraskina LA, Maksimova MYu, Lutokhin GM. Prevalence and character of sleep-disordered breathing in ischemic stroke. CardioSomatika. 2018;9(2):12–16. doi:10.26442/2221-7185_2018.2.12-16. In Russian.Griesbach GS, Howell SN, Masel BE. Obstructive sleep apnea during the chronic stroke recovery period: Comparison between primary haemorrhagic and ischaemic events. J Sleep Res. 2022;31(2):e13460. doi:10.1111/jsr.13460Griesbach GS, Howell SN, Masel BE. Obstructive sleep apnea during the chronic stroke recovery period: Comparison between primary haemorrhagic and ischaemic events. J Sleep Res. 2022;31(2):e13460. doi:10.1111/jsr.13460Шарипов Г.Г., Гераскина Л.А., Фонякин А.В., Лутохин Г.М., Максимова М.Ю. Нарушения дыхания во сне как прогностический фактор неблагоприятного раннего функционального восстановления у больных с ишемическим инсультом. Вестник Российской Военно-медицинской академии. 2019; S 3:169–171. doi:10.17816/rmmar26173.Sharipov GG, Geraskina LA, Fonyakin AV, Lutokhin GM, Maksimova MY. Respiratory disorders in sleep as a prognostic factor of unfavorable early functional recovery in patients with ischemic stroke. Vestnik Rossiiskoy Voenno-Meditsinskoy Akademii = Bulletin of the Russian Military Medical Academy. 2019; S3:169–171. doi:10.17816/rmmar26173. In Russian.Festic N, Alejos D, Bansal V, Mooney L, Fredrickson PA, Castillo PR et al. Sleep apnea in patients hospitalized with acute ischemic stroke: under recognition and associated clinical outcomes. J Clin Sleep Med. 2018;14(1):75–80. doi:10.5664/jcsm.6884Festic N, Alejos D, Bansal V, Mooney L, Fredrickson PA, Castillo PR et al. Sleep apnea in patients hospitalized with acute ischemic stroke: under recognition and associated clinical outcomes. J Clin Sleep Med. 2018;14(1):75–80. doi:10.5664/jcsm.6884Nair R, Radhakrishnan K, Chatterjee A, Gorthi SP, Prabhu VA. Sleep apnea—predictor of functional outcome in acute ischemic stroke. J Stroke Cerebrovasc Dis. 2019;28(3):807–814. doi:10.1016/j.jstrokecerebrovasdis.2018.11.030Nair R, Radhakrishnan K, Chatterjee A, Gorthi SP, Prabhu VA. Sleep apnea—predictor of functional outcome in acute ischemic stroke. J Stroke Cerebrovasc Dis. 2019;28(3):807–814. doi:10.1016/j.jstrokecerebrovasdis.2018.11.030Culebras A, Anwar S. Sleep apnea is a risk factor for stroke and vascular dementia. Curr Neurol Neurosci Rep. 2018;18(8):53. doi:10.1007/s11910-018-0855-1Culebras A, Anwar S. Sleep apnea is a risk factor for stroke and vascular dementia. Curr Neurol Neurosci Rep. 2018;18(8):53. doi:10.1007/s11910-018-0855-1Siccoli MM, Valko PO, Hermann DM, Bassetti CL. Central periodic breathing during sleep in 74 patients with acute ischemic stroke — neurogenic and cardiogenic factors. J Neurol. 2008;255(11):1687–1692. doi:10.1007/s00415-008-0981-9Siccoli MM, Valko PO, Hermann DM, Bassetti CL. Central periodic breathing during sleep in 74 patients with acute ischemic stroke — neurogenic and cardiogenic factors. J Neurol. 2008;255(11):1687–1692. doi:10.1007/s00415-008-0981-9Robbins J, Redline S, Ervin A, Walsleben JA, Ding J, Nieto FJ. Associations of sleep-disordered breathing and cerebral changes on MRI. J Clin Sleep Med. 2005;1(2):159–165. doi:10.5664/jcsm.26311Robbins J, Redline S, Ervin A, Walsleben JA, Ding J, Nieto FJ. Associations of sleep-disordered breathing and cerebral changes on MRI. J Clin Sleep Med. 2005;1(2):159–165. doi:10.5664/jcsm.26311Muñoz R, Durán-Cantolla J, Martínez-Vila E, Gállego J, Rubio R, Aizpuru F et al. Central sleep apnea is associated with increased risk of ischemic stroke in the elderly. Acta Neurol Scand. 2012;126(3):183–188. doi:10.1111/j.1600-0404.2011.01625.xMuñoz R, Durán-Cantolla J, Martínez-Vila E, Gállego J, Rubio R, Aizpuru F et al. Central sleep apnea is associated with increased risk of ischemic stroke in the elderly. Acta Neurol Scand. 2012;126(3):183–188. doi:10.1111/j.1600-0404.2011.01625.xJohnson KG, Johnson DC. Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J Clin Sleep Med. 2010;6(2):131–137. doi:10.5664/jcsm.27760Johnson KG, Johnson DC. Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J Clin Sleep Med. 2010;6(2):131–137. doi:10.5664/jcsm.27760Дадаева В.А., Александров А.А., Орлова А.С., Драпкина О.М. Сон и ожирение: механизмы взаимосвязи. Рациональная фармакотерапия в кардиологии. 2020;16(4):564–570. doi:10.20996/1819-6446-2020-08-10.Dadaeva VA, Aleksandrov AA, Orlova AS, Drapkina OM. Sleep and obesity: mechanisms of association. Ratsional’naja Farmakoterapija v Kardiologii = Rational Pharmacotherapy in Cardiology. 2020;16(4):564–570. doi:10.20996/1819-6446-2020-08-10. In Russian.Лебедева Д.И., Брынза Н.С., Нямцу А.М., Акарачкова Е.С., Орлова А.С. Особенности факторов риска и эпидемиологические характеристики инсульта у женщин в Тюменской области. Профилактическая медицина. 2018;21(2–1):48–54. doi:10.17116/profmed201821248-54Lebedeva DI, Brynza NS, Njamcu AM, Akarachkova ES, Orlova AS. The risk factors and epidemiologic characteristics of stroke in women in the Tyumen region. Profilakticheskaja Meditsina = Preventive Medicine. 2018;21(2–1):48–54. doi:10.17116/profmed201821248-54. In Russian.Han B, Chen WZ, Li YC, Chen J, Zeng ZQ. Sleep and hypertension. Sleep Breath. 2020;24(1):351–356. doi:10.1007/s11325-019-01907-2Han B, Chen WZ, Li YC, Chen J, Zeng ZQ. Sleep and hypertension. Sleep Breath. 2020;24(1):351–356. doi:10.1007/s11325-019-01907-2Salman LA, Shulman R, Cohen JB. Obstructive sleep apnea, hypertension, and cardiovascular risk: epidemiology, pathophysiology, and management. Curr Cardiol Rep. 2020;22(2):6. doi:10.1007/s11886-020-1257-ySalman LA, Shulman R, Cohen JB. Obstructive sleep apnea, hypertension, and cardiovascular risk: epidemiology, pathophysiology, and management. Curr Cardiol Rep. 2020;22(2):6. doi:10.1007/s11886-020-1257-yBikov A, Meszaros M, Schwarz EI. Coagulation and fibrinolysis in obstructive sleep apnoea. Int J Mol Sci. 2021;22(6):2834. doi:10.3390/ijms22062834Bikov A, Meszaros M, Schwarz EI. Coagulation and fibrinolysis in obstructive sleep apnoea. Int J Mol Sci. 2021;22(6):2834. doi:10.3390/ijms22062834Coniglio AC, Mentz RJ. Sleep breathing disorders in heart failure. Heart Fail Clin. 2020;16(1):45–51. doi:10.1016/j.hfc.2019.08.009Coniglio AC, Mentz RJ. Sleep breathing disorders in heart failure. Heart Fail Clin. 2020;16(1):45–51. doi:10.1016/j.hfc.2019.08.009Labarca G, Gower J, Lamperti L, Dreyse J, Jorquera J. Chronic intermittent hypoxia in obstructive sleep apnea: a narrative review from pathophysiological pathways to a precision clinical approach. Sleep Breath. 2020;24(2):751–760. doi:10.1007/s11325-019-01967-4Labarca G, Gower J, Lamperti L, Dreyse J, Jorquera J. Chronic intermittent hypoxia in obstructive sleep apnea: a narrative review from pathophysiological pathways to a precision clinical approach. Sleep Breath. 2020;24(2):751–760. doi:10.1007/s11325-019-01967-4Tanayapong P, Kuna ST. Sleep disordered breathing as a cause and consequence of stroke: A review of pathophysiological and clinical relationships. Sleep Med Rev. 2021;59:101499. doi:10.1016/j.smrv.2021.101499Tanayapong P, Kuna ST. Sleep disordered breathing as a cause and consequence of stroke: A review of pathophysiological and clinical relationships. Sleep Med Rev. 2021;59:101499. doi:10.1016/j.smrv.2021.101499Kryger MH, Roth T, Dement WC. Principles and practice of sleep medicine. 5th Edition. 2011. P. 1723. doi:10.1016/C2009-0-59875-3Kryger MH, Roth T, Dement WC. Principles and practice of sleep medicine. 5th Edition. 2011. P. 1723. doi:10.1016/C2009-0-59875-3Somers V, Javaheri S. Cardiovascular effects of sleeprelated breathing disorders. In: Kryger MH, Roth T, Dement WC, editors. Principles and practices of sleep medicine. 6th ed. Philadelphia, PA: Elsevier; 2017. p. 1243–1252.Somers V, Javaheri S. Cardiovascular effects of sleeprelated breathing disorders. In: Kryger MH, Roth T, Dement WC, editors. Principles and practices of sleep medicine. 6th ed. Philadelphia, PA: Elsevier; 2017. p. 1243–1252.Narkiewicz K, van de Borne PJ, Pesek CA, Dyken ME, Montano N, Somers VK. Selective potentiation of peripheral chemoreflex sensitivity in obstructive sleep apnea. Circulation. 1999;99(9):1183–1189. doi:10.1161/01.cir.99.9.1183Narkiewicz K, van de Borne PJ, Pesek CA, Dyken ME, Montano N, Somers VK. Selective potentiation of peripheral chemoreflex sensitivity in obstructive sleep apnea. Circulation. 1999;99(9):1183–1189. doi:10.1161/01.cir.99.9.1183Sharma S, Culebras A. Sleep apnoea and stroke. Stroke Vasc Neurol 2016;1(4):185–191. doi:10.1136/svn‑2016–000038Sharma S, Culebras A. Sleep apnoea and stroke. Stroke Vasc Neurol 2016;1(4):185–191. doi:10.1136/svn‑2016–000038Hou H, Zhao Y, Yu W, Dong H, Xue X, Ding J et al. Association of obstructive sleep apnea with hypertension: a systematic review and meta-analysis. J Glob Health. 2018;8(1):010405. doi:10.7189/jogh.08.010405Hou H, Zhao Y, Yu W, Dong H, Xue X, Ding J et al. Association of obstructive sleep apnea with hypertension: a systematic review and meta-analysis. J Glob Health. 2018;8(1):010405. doi:10.7189/jogh.08.010405Logan AG, Perlikowski SM, Mente A, Tisler A, Tkacova R, Niroumand M et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens. 2001;19(12):2271– 2277. doi:10.1097/00004872-200112000–00022Logan AG, Perlikowski SM, Mente A, Tisler A, Tkacova R, Niroumand M et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens. 2001;19(12):2271– 2277. doi:10.1097/00004872-200112000–00022Waltz X, Beaudin AE, Hanly PJ, Mitsis GD, Poulin MJ. Effects of continuous positive airway pressure and isocapnichypoxia on cerebral autoregulation in patients with obstructive sleep apnoea. J Physiol. 2016;594(23):7089–7104. doi:10.1113/JP272967Waltz X, Beaudin AE, Hanly PJ, Mitsis GD, Poulin MJ. Effects of continuous positive airway pressure and isocapnichypoxia on cerebral autoregulation in patients with obstructive sleep apnoea. J Physiol. 2016;594(23):7089–7104. doi:10.1113/JP272967Baril AA, Gagnon K, Brayet P, Montplaisir J, Carrier J, Soucy JP et al. Obstructive sleep apnea during REM sleep and daytime cerebral functioning: A regional cerebral blood flow study using high-resolution SPECT. J Cereb Blood Flow Metab. 2020;40(6):1230–1241. doi:10.1177/0271678X18814106Baril AA, Gagnon K, Brayet P, Montplaisir J, Carrier J, Soucy JP et al. Obstructive sleep apnea during REM sleep and daytime cerebral functioning: A regional cerebral blood flow study using high-resolution SPECT. J Cereb Blood Flow Metab. 2020;40(6):1230–1241. doi:10.1177/0271678X18814106Durgan DJ, Bryan Jr RM. Cerebrovascular consequences of obstructive sleep apnea. J Am Heart Assoc. 2012;1(4):e000091. doi:10.1161/JAHA.111.000091Durgan DJ, Bryan Jr RM. Cerebrovascular consequences of obstructive sleep apnea. J Am Heart Assoc. 2012;1(4):e000091. doi:10.1161/JAHA.111.000091Sharma VK, Teoh HL, Paliwal PR, Chong VF, Chan BP, Sinha AK. Reversed Robin Hood syndrome in a patient with luxury perfusion after acute ischemic stroke. Circulation. 2011;123(7):243– 244. doi:10.1161/CIRCULATIONAHA.110.972000Sharma VK, Teoh HL, Paliwal PR, Chong VF, Chan BP, Sinha AK. Reversed Robin Hood syndrome in a patient with luxury perfusion after acute ischemic stroke. Circulation. 2011;123(7):243– 244. doi:10.1161/CIRCULATIONAHA.110.972000Prabhakar NR, Semenza GL. Adaptive and maladaptive cardiorespiratory responses to continuous and intermittent hypoxia mediated by hypoxia-inducible factors 1 and 2. Physiol Rev. 2012;92(3):967–1003. doi:10.1152/physrev.00030.2011Prabhakar NR, Semenza GL. Adaptive and maladaptive cardiorespiratory responses to continuous and intermittent hypoxia mediated by hypoxia-inducible factors 1 and 2. Physiol Rev. 2012;92(3):967–1003. doi:10.1152/physrev.00030.2011Baessler A, Nadeem R, Harvey M, Madbouly E, Younus A, Sajid H et al. Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers—a metaanalysis. J Inflamm. 2013;10:13. doi:10.1186/1476-9255-10-13Baessler A, Nadeem R, Harvey M, Madbouly E, Younus A, Sajid H et al. Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers—a metaanalysis. J Inflamm. 2013;10:13. doi:10.1186/1476-9255-10-13Bironneau V, Tamisier R, Trzepizur W, Andriantsitohaina R, Berger M, Goupil F et al. Sleep apnoea and endothelial dysfunction: an individual patient data meta-analysis. Sleep Med Rev. 2020;52:101309. doi:10.1016/j.smrv.2020.101309Bironneau V, Tamisier R, Trzepizur W, Andriantsitohaina R, Berger M, Goupil F et al. Sleep apnoea and endothelial dysfunction: an individual patient data meta-analysis. Sleep Med Rev. 2020;52:101309. doi:10.1016/j.smrv.2020.101309Chen CY, Chen CL, Yu CC, Chen TT, Tseng ST, Ho CH. Association of inflammation and oxidative stress with obstructive sleep apnea in ischemic stroke patients. Sleep Med. 2015;16(1):113– 118. doi:10.1016/j.sleep.2014.07.027Chen CY, Chen CL, Yu CC, Chen TT, Tseng ST, Ho CH. Association of inflammation and oxidative stress with obstructive sleep apnea in ischemic stroke patients. Sleep Med. 2015;16(1):113– 118. doi:10.1016/j.sleep.2014.07.027Ifergane G, Ovanyan A, Toledano R, Goldbart A, AbuSalame I, Tal A et al. Obstructive sleep apnea in acute stroke: a role for systemic inflammation. Stroke. 2016;47(5):1207–1212. doi:10.1161/STROKEAHA.115.011749Ifergane G, Ovanyan A, Toledano R, Goldbart A, AbuSalame I, Tal A et al. Obstructive sleep apnea in acute stroke: a role for systemic inflammation. Stroke. 2016;47(5):1207–1212. doi:10.1161/STROKEAHA.115.011749Ayas NT, Pittman S, MacDonald M, White DP. Assessment of a wrist-worn device in the detection of obstructive sleep apnea. Sleep Med. 2003;4(5):435–442. doi:10.1016/s1389-9457(03)00111-4Ayas NT, Pittman S, MacDonald M, White DP. Assessment of a wrist-worn device in the detection of obstructive sleep apnea. Sleep Med. 2003;4(5):435–442. doi:10.1016/s1389-9457(03)00111-4Kunz AB, Kraus J, Young P, Reuss R, Wipfler P, Oschmann P et al. Biomarkers of inflammation and endothelial dysfunction in stroke with and without sleep apnea. Cerebrovasc Dis. 2012;33(5):453–460. doi:10.1159/000336120Kunz AB, Kraus J, Young P, Reuss R, Wipfler P, Oschmann P et al. Biomarkers of inflammation and endothelial dysfunction in stroke with and without sleep apnea. Cerebrovasc Dis. 2012;33(5):453–460. doi:10.1159/000336120Medeiros CA, de Bruin VM, Andrade GM, Coutinho WM, de Castro-Silva C, de Bruin PF. Obstructive sleep apnea and biomarkers of inflammation in ischemic stroke. Acta Neurol Scand. 2012;126(1):17–22. doi:10.1111/j.1600-0404.2011.01589.xMedeiros CA, de Bruin VM, Andrade GM, Coutinho WM, de Castro-Silva C, de Bruin PF. Obstructive sleep apnea and biomarkers of inflammation in ischemic stroke. Acta Neurol Scand. 2012;126(1):17–22. doi:10.1111/j.1600-0404.2011.01589.xNadeem R, Molnar J, Madbouly EM, Nida M, Aggarwal S, Sajid H et al. Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. J Clin Sleep Med. 2013;9(10):1003–1012. doi:10.5664/jcsm.3070Nadeem R, Molnar J, Madbouly EM, Nida M, Aggarwal S, Sajid H et al. Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. J Clin Sleep Med. 2013;9(10):1003–1012. doi:10.5664/jcsm.3070Testelmans D, Tamisier R, Barone-Rochette G, Baguet JP, Roux-Lombard P, Pépin JL et al. Profile of circulating cytokines: impact of OSA, obesity and acute cardiovascular events. Cytokine. 2013;62(2):210–216. doi:10.1016/j.cyto.2013.02.021Testelmans D, Tamisier R, Barone-Rochette G, Baguet JP, Roux-Lombard P, Pépin JL et al. Profile of circulating cytokines: impact of OSA, obesity and acute cardiovascular events. Cytokine. 2013;62(2):210–216. doi:10.1016/j.cyto.2013.02.021Орлова А.С., Меньшова Н.И., Румянцева С.А., Силина Е.В., Ступин В. А., Орлов В. А. и др. Сердечно-сосудистая коморбидность и дисбаланс свободнорадикальных процессов у больных с острым нарушением мозгового кровообращения. Казанский медицинский журнал. 2013;94(6):813– 817.Orlova AS, Men’shova NI, Rumjanceva SA, Silina EV, Stupin VA, Orlov VA et al. Cardiovascular comorbidity and free radical mediated processes imbalance in patients with acute stroke. Kazanskij Meditsinskij Zhurnal = Kazan Medical Journal. 2013;94(6):813–817. In Russian.Cereda CW, Tamisier R, Manconi M, Andreotti J, Frangi J, Pifferini V et al. Endothelial dysfunction and arterial stiffness in ischemic stroke: the role of sleep-disordered breathing. Stroke. 2013;44(4):1175–1178. doi:10.1161/STROKEAHA.111.000112Cereda CW, Tamisier R, Manconi M, Andreotti J, Frangi J, Pifferini V et al. Endothelial dysfunction and arterial stiffness in ischemic stroke: the role of sleep-disordered breathing. Stroke. 2013;44(4):1175–1178. doi:10.1161/STROKEAHA.111.000112Cadby G, McArdle N, Briffa T, Hillman DR, Simpson L, Knuiman M et al. Severity of OSA is an independent predictor of incident atrial fibrillation hospitalization in a large sleep-clinic cohort. Chest. 2015;148(4):945–952. doi:10.1378/chest.15-0229Cadby G, McArdle N, Briffa T, Hillman DR, Simpson L, Knuiman M et al. Severity of OSA is an independent predictor of incident atrial fibrillation hospitalization in a large sleep-clinic cohort. Chest. 2015;148(4):945–952. doi:10.1378/chest.15-0229Mehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchner HL et al. Association of nocturnal arrhythmias with sleepdisordered breathing: the sleep heart health study. Am J Respir Crit Care Med. 2006;173(8):910–916. doi:10.1164/rccm.200509-1442OCMehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchner HL et al. Association of nocturnal arrhythmias with sleepdisordered breathing: the sleep heart health study. Am J Respir Crit Care Med. 2006;173(8):910–916. doi:10.1164/rccm.200509-1442OCLipford MC, Flemming KD, Calvin AD, Mandrekar J, Brown RD Jr, Somers VK et al. Associations between cardioembolic stroke and obstructive sleep apnea. Sleep. 2015;38(11):1699–1705. doi:10.5665/sleep.5146Lipford MC, Flemming KD, Calvin AD, Mandrekar J, Brown RD Jr, Somers VK et al. Associations between cardioembolic stroke and obstructive sleep apnea. Sleep. 2015;38(11):1699–1705. doi:10.5665/sleep.5146Poli M, Philip P, Taillard J, Debruxelles S, Renou P, Orgogozo JM et al. Atrial fibrillation as a major cause of stroke in apneic patients: a prospective study. Sleep Med. 2017;30:251–254. doi:10.1016/j.sleep.2015.07.031Poli M, Philip P, Taillard J, Debruxelles S, Renou P, Orgogozo JM et al. Atrial fibrillation as a major cause of stroke in apneic patients: a prospective study. Sleep Med. 2017;30:251–254. doi:10.1016/j.sleep.2015.07.031Selim B, Roux FJ. Stroke and sleep disorders. Sleep Med Clin. 2012;7(4):597–607. doi:10.1016/j.jsmc.2012.08.007Selim B, Roux FJ. Stroke and sleep disorders. Sleep Med Clin. 2012;7(4):597–607. doi:10.1016/j.jsmc.2012.08.007Mojadidi MK, Bokhoor PI, Gevorgyan R, Noureddin N, MacLellan WC, Wen E et al. Sleep apnea in patients with and without a right-to-left shunt. J Clin Sleep Med. 2015;11(11):1299– 1304. doi:10.5664/jcsm.5190Mojadidi MK, Bokhoor PI, Gevorgyan R, Noureddin N, MacLellan WC, Wen E et al. Sleep apnea in patients with and without a right-to-left shunt. J Clin Sleep Med. 2015;11(11):1299– 1304. doi:10.5664/jcsm.5190Marulanda-Londono E, Chaturvedi S. The interplay between obstructive sleep apnea and atrial fibrillation. Fron Neurol. 2017;8:668. doi:10.3389/fneur.2017.00668Marulanda-Londono E, Chaturvedi S. The interplay between obstructive sleep apnea and atrial fibrillation. Fron Neurol. 2017;8:668. doi:10.3389/fneur.2017.00668Cho JG, Witting PK, Verma M, Wu BJ, Shanu A, Kairaitis K et al. Tissue vibration induces carotid artery endothelial dysfunction: a mechanism linking snoring and carotid atherosclerosis? Sleep. 2011;34(6):751–757. doi:10.5665/SLEEP.1042Cho JG, Witting PK, Verma M, Wu BJ, Shanu A, Kairaitis K et al. Tissue vibration induces carotid artery endothelial dysfunction: a mechanism linking snoring and carotid atherosclerosis? Sleep. 2011;34(6):751–757. doi:10.5665/SLEEP.1042Kim J, Pack AI, Riegel BJ, Chirinos JA, Hanlon A, Lee SK et al. Objective snoring time and carotid intima-media thickness in non-apneic female snorers. J Sleep Res. 2017;26(2):147–150. doi:10.1111/jsr.12471Kim J, Pack AI, Riegel BJ, Chirinos JA, Hanlon A, Lee SK et al. Objective snoring time and carotid intima-media thickness in non-apneic female snorers. J Sleep Res. 2017;26(2):147–150. doi:10.1111/jsr.12471Salepci B, Fidan A, Ketenci SC, Parmaksiz ET, Comert SS, Kiral N et al. The effect of obstructive sleep apnea syndrome and snoring severity to intimamedia thickening of carotid artery. Sleep Breath. 2015;19(1):239–246. doi:10.1007/s11325-014-1002-0Salepci B, Fidan A, Ketenci SC, Parmaksiz ET, Comert SS, Kiral N et al. The effect of obstructive sleep apnea syndrome and snoring severity to intimamedia thickening of carotid artery. Sleep Breath. 2015;19(1):239–246. doi:10.1007/s11325-014-1002-0Kim J, Mohler 3rd ER, Keenan BT, Maislin D, Arnardottir ES, Gislason T et al. Carotid artery wall thickness in obese and nonobese adults with obstructive sleep apnea before and following positive airway pressure treatment. Sleep. 2017;40(9):zsx126. doi:10.1093/sleep/zsx126Kim J, Mohler 3rd ER, Keenan BT, Maislin D, Arnardottir ES, Gislason T et al. Carotid artery wall thickness in obese and nonobese adults with obstructive sleep apnea before and following positive airway pressure treatment. Sleep. 2017;40(9):zsx126. doi:10.1093/sleep/zsx126Kim TJ, Ko S-B, Jeong H-G, Lee JS, Kim CK, Kim Y et al. Nocturnal desaturation in the stroke unit is associated with wakeup ischemic stroke. Stroke. 2016;47(7):1748–1753. doi:10.1161/STROKEAHA.116.013266Kim TJ, Ko S-B, Jeong H-G, Lee JS, Kim CK, Kim Y et al. Nocturnal desaturation in the stroke unit is associated with wakeup ischemic stroke. Stroke. 2016;47(7):1748–1753. doi:10.1161/STROKEAHA.116.013266Furtner M, Staudacher M, Frauscher B, Brandauer E, Esnaola y Rojas MM, Gschliesser V et al. Cerebral vasoreactivity decreases overnight in severe obstructive sleep apnea syndrome: a study of cerebral hemodynamics. Sleep Med. 2009;10(8):875–881. doi:10.1016/j.sleep.2008.09.011Furtner M, Staudacher M, Frauscher B, Brandauer E, Esnaola y Rojas MM, Gschliesser V et al. Cerebral vasoreactivity decreases overnight in severe obstructive sleep apnea syndrome: a study of cerebral hemodynamics. Sleep Med. 2009;10(8):875–881. doi:10.1016/j.sleep.2008.09.011Chin K, Ohi M, Kita H, Noguchi T, Otsuka N, Tsuboi T et al. Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 1996;153(6Pt1):1972– 1976. doi:10.1164/ajrccm.153.6.8665063Chin K, Ohi M, Kita H, Noguchi T, Otsuka N, Tsuboi T et al. Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 1996;153(6Pt1):1972– 1976. doi:10.1164/ajrccm.153.6.8665063Reichmuth KJ, Dopp JM, Barczi SR, Skatrud JB, Wojdyla P, Hayes DJ et al. Impaired vascular regulation in patients with obstructive sleep apnea: effects of continuous positive airway pressure treatment. Am J Respir Crit Care Med. 2009;180(11): 1143–1150.Reichmuth KJ, Dopp JM, Barczi SR, Skatrud JB, Wojdyla P, Hayes DJ et al. Impaired vascular regulation in patients with obstructive sleep apnea: effects of continuous positive airway pressure treatment. Am J Respir Crit Care Med. 2009;180(11): 1143–1150.Elfil M, Eldokmak M, Baratloo A, Ahmed N, Amin HP, Koo BB. Pathophysiologic mechanisms, neuroimaging and treatment in wake-up stroke. CNS Spectr. 2020;25(4):460–467. doi:10.1017/S1092852919001354Elfil M, Eldokmak M, Baratloo A, Ahmed N, Amin HP, Koo BB. Pathophysiologic mechanisms, neuroimaging and treatment in wake-up stroke. CNS Spectr. 2020;25(4):460–467. doi:10.1017/S1092852919001354Mohammad Y, Almutlaq A, Al-Ruwaita A, Aldrees A, Alsubaie A, Al-Hussain F. Stroke during sleep and obstructive sleep apnea: there is a link. Neurol Sci. 2019;40(5):1001–1005. doi:10.1007/s10072-019-03753-2Mohammad Y, Almutlaq A, Al-Ruwaita A, Aldrees A, Alsubaie A, Al-Hussain F. Stroke during sleep and obstructive sleep apnea: there is a link. Neurol Sci. 2019;40(5):1001–1005. doi:10.1007/s10072-019-03753-2Hsieh S-W, Lai C–L, Liu C-K, Hsieh C-F, Hsu C-Y. Obstructive sleep apnea linked to wake-up strokes. J Neurol. 2012;259(7):1433–1439. doi:10.1007/s00415-011-6370-9Hsieh S-W, Lai C–L, Liu C-K, Hsieh C-F, Hsu C-Y. Obstructive sleep apnea linked to wake-up strokes. J Neurol. 2012;259(7):1433–1439. doi:10.1007/s00415-011-6370-9Ozdemir O, Beletsky V, Hachinski V, Spence JD. Cerebrovascular events on awakening, patent foramen ovale and obstructive sleep apnea syndrome. J Neurol Sci. 2008;268(1– 2):193–194. doi:10.1016/j.jns.2007.11.010Ozdemir O, Beletsky V, Hachinski V, Spence JD. Cerebrovascular events on awakening, patent foramen ovale and obstructive sleep apnea syndrome. J Neurol Sci. 2008;268(1– 2):193–194. doi:10.1016/j.jns.2007.11.010Ciccone A, Proserpio P, Roccatagliata DV, Nichelatti M, Gigli GL, Parati G et al. Wake-up stroke and TIA due to paradoxical embolism during long obstructive sleep apnoeas: a cross-sectional study. Thorax. 2013;68(1):97–104. doi:10.1136/thoraxjnl‑2012-201643Ciccone A, Proserpio P, Roccatagliata DV, Nichelatti M, Gigli GL, Parati G et al. Wake-up stroke and TIA due to paradoxical embolism during long obstructive sleep apnoeas: a cross-sectional study. Thorax. 2013;68(1):97–104. doi:10.1136/thoraxjnl‑2012-201643Seiler A, Camilo M, Korostovtseva L, Haynes AG, Brill AK, Horvath T et al. Prevalence of sleep-disordered breathing after stroke and TIA: a meta-analysis. Neurology. 2019;92(7):648–654. doi:10.1212/WNL.0000000000006904Seiler A, Camilo M, Korostovtseva L, Haynes AG, Brill AK, Horvath T et al. Prevalence of sleep-disordered breathing after stroke and TIA: a meta-analysis. Neurology. 2019;92(7):648–654. doi:10.1212/WNL.0000000000006904Brown DL, Mowla A, McDermott M, Morgenstern LB, Hegeman 3rd G, Smith MA et al. Ischemic stroke subtype and presence of sleep-disordered breathing: the BASIC sleep apnea study. J Stroke Cerebrovasc Dis. 2015;24(2):388–393. doi:10.1016/j.jstrokecerebrovasdis.2014.09.007Brown DL, Mowla A, McDermott M, Morgenstern LB, Hegeman 3rd G, Smith MA et al. Ischemic stroke subtype and presence of sleep-disordered breathing: the BASIC sleep apnea study. J Stroke Cerebrovasc Dis. 2015;24(2):388–393. doi:10.1016/j.jstrokecerebrovasdis.2014.09.007Brown DL, McDermott M, Mowla A, De Lott L, Morgenstern LB, Kerber KA et al. Brainstem infarction and sleepdisordered breathing in the BASIC sleep apnea study. Sleep Med. 2014;15(8):887–891. doi:10.1016/j.sleep.2014.04.003Brown DL, McDermott M, Mowla A, De Lott L, Morgenstern LB, Kerber KA et al. Brainstem infarction and sleepdisordered breathing in the BASIC sleep apnea study. Sleep Med. 2014;15(8):887–891. doi:10.1016/j.sleep.2014.04.003Pattinson KTS, Mitsis GD, Harvey AK, Jbabdi S, Dirckx S, Mayhew SD et al. Determination of the human brainstem respiratory control network and its cortical connections in vivo using functional and structural imaging. Neuroimage. 2009;44(2):295–305. doi:10.1016/j.neuroimage.2008.09.007Pattinson KTS, Mitsis GD, Harvey AK, Jbabdi S, Dirckx S, Mayhew SD et al. Determination of the human brainstem respiratory control network and its cortical connections in vivo using functional and structural imaging. Neuroimage. 2009;44(2):295–305. doi:10.1016/j.neuroimage.2008.09.007Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: pathophysiology and treatment. Chest. 2007;131(2):595– 607. doi:10.1378/chest.06.2287Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: pathophysiology and treatment. Chest. 2007;131(2):595– 607. doi:10.1378/chest.06.2287Morrell MJ, Heywood P, Moosavi SH, Guz A, Stevens J. Unilateral focal lesions in the rostrolateral medulla influence chemosensitivity and breathing measured during wakefulness, sleep, and exercise. J Neurol Neurosurg Psychiatry. 1999;67(5):637–645. doi:10.1136/jnnp.67.5.637Morrell MJ, Heywood P, Moosavi SH, Guz A, Stevens J. Unilateral focal lesions in the rostrolateral medulla influence chemosensitivity and breathing measured during wakefulness, sleep, and exercise. J Neurol Neurosurg Psychiatry. 1999;67(5):637–645. doi:10.1136/jnnp.67.5.637Smith JC, Goldberg SJ, Shall MS. Phenotype and contractile properties of mammalian tongue muscles innervated by the hypoglossal nerve. Respir Physiol Neurobiol. 2005; 147(2–3): 253–262. doi:10.1016/j.resp.2005.02.016Smith JC, Goldberg SJ, Shall MS. Phenotype and contractile properties of mammalian tongue muscles innervated by the hypoglossal nerve. Respir Physiol Neurobiol. 2005; 147(2–3): 253–262. doi:10.1016/j.resp.2005.02.016Sands SA, Eckert DJ, Jordan AS, Edwards BA, Owens RL, Butler JP et al. Enhanced upper-airway muscle responsiveness is a distinct feature of over-weight/obese individuals without sleep apnea. Am J Respir Crit Care Med. 2014;190(8):930–937. doi:10.1164/rccm.201404-0783OCSands SA, Eckert DJ, Jordan AS, Edwards BA, Owens RL, Butler JP et al. Enhanced upper-airway muscle responsiveness is a distinct feature of over-weight/obese individuals without sleep apnea. Am J Respir Crit Care Med. 2014;190(8):930–937. doi:10.1164/rccm.201404-0783OCBarer DH. The natural history and functional consequences of dysphagia after hemispheric stroke. J Neurol Neurosurg Psychiatry. 1989;52(2):236–241. doi:10.1136/jnnp.52.2.236Barer DH. The natural history and functional consequences of dysphagia after hemispheric stroke. J Neurol Neurosurg Psychiatry. 1989;52(2):236–241. doi:10.1136/jnnp.52.2.236Parra O, Arboix A, Bechich S, García-Eroles L, Montserrat JM, López JA et al. Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack. Am J Respir Crit Care Med. 2000;161(2Pt1):375–380. doi:10.1164/ajrccm.161.2.9903139Parra O, Arboix A, Bechich S, García-Eroles L, Montserrat JM, López JA et al. Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack. Am J Respir Crit Care Med. 2000;161(2Pt1):375–380. doi:10.1164/ajrccm.161.2.9903139Szücs A, Vitrai J, Janszky J, Migléczi G, Bódizs R, Halasz P et al. Pathological sleep apnoea frequency remains permanent in ischaemic stroke and it is transient in haemorrhagic stroke. Eur Neurol. 2002;47(1):15–19. doi:10.1159/000047941Szücs A, Vitrai J, Janszky J, Migléczi G, Bódizs R, Halasz P et al. Pathological sleep apnoea frequency remains permanent in ischaemic stroke and it is transient in haemorrhagic stroke. Eur Neurol. 2002;47(1):15–19. doi:10.1159/000047941De Paolis F, Colizzi E, Milioli G, Grassi A, Riccardi S, Parrino L et al. Acute shift of a case of moderate obstructive sleep apnea syndrome towards one of severe central sleep apnea syndrome after an ischemic stroke. Sleep Med. 2012;13(6): 763– 766. doi:10.1016/j.sleep.2012.01.012De Paolis F, Colizzi E, Milioli G, Grassi A, Riccardi S, Parrino L et al. Acute shift of a case of moderate obstructive sleep apnea syndrome towards one of severe central sleep apnea syndrome after an ischemic stroke. Sleep Med. 2012;13(6): 763– 766. doi:10.1016/j.sleep.2012.01.012Alexiev F, Brill AK, Ott SR, Duss S, Schmidt M, Bassetti CL. Sleep-disordered breathing and stroke: chicken or egg? J Thorac Dis. 2018;10(Suppl34):4244–4252. doi:10.21037/jtd.2018.12.66Alexiev F, Brill AK, Ott SR, Duss S, Schmidt M, Bassetti CL. Sleep-disordered breathing and stroke: chicken or egg? J Thorac Dis. 2018;10(Suppl34):4244–4252. doi:10.21037/jtd. 2018.12.66Osman AM, Carter SG, Carberry JC, Eckert DJ. Obstructive sleep apnea: current perspectives. Nat Sci Sleep. 2018;10:21–34. doi:10.2147/NSS.S124657Osman AM, Carter SG, Carberry JC, Eckert DJ. Obstructive sleep apnea: current perspectives. Nat Sci Sleep. 2018;10:21–34. doi:10.2147/NSS.S124657Iliff JJ, Wang M, Liao Y, Plogg BA, Peng W, Gundersen GA et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012;4(147):147ra111. doi:10.1126/scitranslmed.3003748Iliff JJ, Wang M, Liao Y, Plogg BA, Peng W, Gundersen GA et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012;4(147):147ra111. doi:10.1126/scitranslmed.3003748Jessen NA, Munk AS, Lundgaard I, Nedergaard M. The glymphatic system: a beginner’s guide. Neurochem Res. 2015;40(12):2583–2599. doi:10.1007/s11064-015-1581-6Jessen NA, Munk AS, Lundgaard I, Nedergaard M. The glymphatic system: a beginner’s guide. Neurochem Res. 2015;40(12):2583–2599. doi:10.1007/s11064-015-1581-6Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373–377. doi:10.1126/science.1241224Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373–377. doi:10.1126/science.1241224Pu T, Zou W, Feng W, Zhang Y, Wang L, Wang H et al. Persistent malfunction of glymphatic and meningeal lymphatic drainage in a mouse model of subarachnoid hemorrhage. Exp Neurobiol. 2019;28(1):104–118. doi:10.5607/en.2019.28.1.104Pu T, Zou W, Feng W, Zhang Y, Wang L, Wang H et al. Persistent malfunction of glymphatic and meningeal lymphatic drainage in a mouse model of subarachnoid hemorrhage. Exp Neurobiol. 2019;28(1):104–118. doi:10.5607/en.2019.28.1.104Rasmussen MK, Mestre H, Nedergaard M. The glymphatic pathway in neurological disorders. Lancet Neurol. 2018;17(11):1016–1024. doi:10.1016/S1474-4422(18)30318-1Rasmussen MK, Mestre H, Nedergaard M. The glymphatic pathway in neurological disorders. Lancet Neurol. 2018;17(11):1016–1024. doi:10.1016/S1474-4422(18)30318-1Mestre H, Du T, Sweeney AM, Liu G, Samson AJ, Peng W et al. Cerebrospinal fluid influx drives acute ischemic tissue swelling. Science. 2020;367(6483):eaax7171. doi:10.1126/science.aax7171Mestre H, Du T, Sweeney AM, Liu G, Samson AJ, Peng W et al. Cerebrospinal fluid influx drives acute ischemic tissue swelling. Science. 2020;367(6483):eaax7171. doi:10.1126/science.aax7171Korostovtseva L. Ischemic stroke and sleep: the linking genetic factors. Cardiol Ther. 2021;10(2):349–375. doi:10.1007/s40119-021-00231-9Korostovtseva L. Ischemic stroke and sleep: the linking genetic factors. Cardiol Ther. 2021;10(2):349–375. doi:10.1007/s40119-021-00231-9Zhang W, Zhao ZR, Dai CF, Zhang R, Chen J, Tian HJ et al. Correlation between Calpain‑10 single-nucleotide polymorphisms and obstructive sleep apnea/hypopnoea syndrome with ischemic stroke in a Chinese population: a population-based study. Medicine (Baltimore). 2017;96(16):e6570. doi:10.1097/MD.0000000000006570Zhang W, Zhao ZR, Dai CF, Zhang R, Chen J, Tian HJ et al. Correlation between Calpain‑10 single-nucleotide polymorphisms and obstructive sleep apnea/hypopnoea syndrome with ischemic stroke in a Chinese population: a population-based study. Medicine (Baltimore). 2017;96(16):e6570. doi:10.1097/MD.0000000000006570

The authors declare that there are no conflicts of interest present.