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(Stroke. 2007;38:250.)
© 2007 American Heart Association, Inc.

Letters to the Editor

Response to Letter by Lavie and Lavie

Roberto Munoz, MD

Department of Neurology, Hospital de Navarra, Pamplona, Spain

Joaquín Duran-Cantolla, MD, PhD

Sleep Unit, Department of Pneumology, Hospital Txagorritxu, Vitoria-Gasteiz, Spain

Eduardo Martínez-Vila, MD, PhD

Department of Neurology, Clínica Universitaria de Navarra, Pamplona, Spain

Jaime Gallego, MD, PhD

Department of Neurology, Hospital de Navarra, Pamplona, Spain

Ramón Rubio, MD, PhD

Sleep Unit, Department of Pneumology, Hospital Txagorritxu, Vitoria-Gasteiz, Spain

Felipe Aizpuru, MD, PhD

Research Unit, Hospital Txagorritxu, Vitoria-Gasteiz, Spain

Germán De La Torre, MD, PhD

Sleep Unit, Department of Pneumology, Hospital Txagorritxu, Vitoria-Gasteiz, Spain

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Response:

We are very grateful to Lavie and Lavie for their polite correction. As they point out, this variable (T90) should be expressed in Table 2 in "percentage of sleep time spent below 90% saturation," not in seconds.

After revising data referring to T90 variable in both groups, we didn’t find any mistakes (ischemic stroke: median 14.6, SD 18.44, nonischemic stroke: median 16.12, SD 22.51). We think it could be possible to have some explanations for these findings. First, as you can see in Table 2, differences of AHI between 2 groups are significant (P=0,049) but very small (ischemic stroke: median 28, SD 17, nonischemic stroke median 20.1, SD 17), so T90 could be similar in both groups. Moreover, median AHI is moderate in severity, and for that reason it is not surprising that T90 is not very high. Second, it is important to remind that we have studied old people with many associated medical conditions not considered in exclusion criteria (as for example moderate chronic obstructive pulmonary disease or chronic bronchitis) that could have influence in respiratory function, and for that reason we think that T90 could have been determined not only by AHI.

Even though hypoxia and reoxygenation phenomena are responsible for oxidative stress and endothelial damage, as Lavie and Lavie have demonstrated, this is probably not the single mechanism involved in the increased vascular risk in obstructive sleep apnea hypopnea (OSAH) patients. For example, it is well know that repeated episodes of apnea and hypopnea . . . [Full Text of this Article]

Related Article:

Is the Severity of Sleep Apnea Associated With Ischemic Stroke in the Elderly?

Peretz Lavie and Lena Lavie
Stroke 2007 38: 249. [Extract] [Full Text] [PDF]