Sleep Apnea & Cavernous Malformation

Research has demonstrated an interaction between a lack of oxygen during sleep (hypoxia) and cerebral cavernous malformation (CCM). Though research is ongoing, it is thought that this hypoxia may accelerate CCM disease by promoting neuroinflammation and other factors. Sleep disordered breathing, such as sleep apnea, is an area of special attention for cavernous malformation patients due to it causing intermittent hypoxia.

Obstructive Sleep Apnea (OSA) is defined by interrupted breathing during sleep due to airway obstruction with an ongoing respiratory effort. It is characterized by brief and repeated interruptions of breathing.

Central Sleep Apnea (CSA) is characterized by a lack of drive to breathe during sleep because the brain doesn’t send proper signals to the muscles that control breathing. There are many types of central sleep apnea, and it is less common than obstructive sleep apnea.

Sleep apnea may result in varying levels of hypoxia which in turn may exacerbate cerebral cavernous malformations. Sleep apnea may also be associated with CCM symptoms. Experts believe that if a patient with CCM also has any degree of sleep apnea, it should be treated more aggressively than in the general population.

Dr. Atif Zafar  adds, “Obstructive sleep apnea and high blood pressure are risk factors for hemorrhagic strokes. Although research is underway to learn more about how sleep apnea can affect brain cavernomas, most cavernoma specialists agree that screening for sleep apnea and optimally, treating it is important.”

If you have been diagnosed with cavernous malformation, speak with your family physician or a member of your neuro team about a referral for a sleep study, especially if you have sleep concerns.  It may be helpful to print the PDF version of this page to bring with you for the discussion. Your physician will likely also review any accompanying symptoms of sleep apnea with you. These include 

• snoring
• daytime sleepiness
• headaches 
• and other symptoms. 

A study can be done at home or in a clinical setting depending on various factors.

Updated September 3, 2024