•Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by recurrent episodes of partial or complete obstruction of the upper airway, leading to intermittent hypoxia and frequent arousals during sleep. •Many studies have demonstrated that the patient with OSA showed relatively high prevalence of atherosclerotic neurovascular and cardiovascular disease. –Variable mechanisms : hypoxia and arousal negatively affect blood pressure and coagulation factors Repetitive arterial wall injury by vibration is a cause of atherosclerosis •Silent cerebrovascular lesions considered to be part of the preconditioning...

Subjects •489 consecutive patients who underwent polysomnography and upper airway CT between March 2011 and March 2018 •We included who underwent brain MRI among them within 3 years interval with airway CT –We tried exclude silent cerebrovascular lesions mimicking disease such as adult-onset leukoencephalopathies or demyelinating disease, which cause white matter hyperintensities on MRI •Finally, 60 patients (45 male, mean age 54.5 ± 10.8 years old, age range 19-77 years old) were enrolled as subjects (Fig. 1) Polysomnography •Overnight PSG (Alice 5, 19 channels; Philips...

Comparison of clinical factors for the each PVH grade groups (Fig. 5) •The mean age showed a significant difference among the groups - PVH grade 0 50.5±10.3; PVH grade1 55.5±6.8; PVH grade 2 55.9±12.7; PVH grade3 63.5±9; PVH grade 4 68.5±12 years, P = 0.018 •Subjects with hypertension were more prevalent in PVH grade 4 and the difference in prevalence was significant among the PVH grade groups - 100% in PVH grade 4, P = 0.036 •Smoking history demonstrated a significant difference among the PVH...

Limitations •Potential selection bias is unknown §Limited samples of a single medical center •Retrospective study: Brain MRI and airway CT were not performed concurrently •PVH grading: - In some cases, it is difficult to determine PVH grade, then twoobservers had discussion about those (very good inter-observer agreement, ICC=0.961) •Information about treatment of OSA - Insufficient information about evaluation after treatment for OSA in the medical record Conclusion • We found that the mean age, hypertension, smoking, apnea index, CarACS showed a significant difference among the...

Eun-Ju Kang, M.D., Ph.D. Associate professor, Cardiovascular Imaging, Department of Radiology, Dong-A University College of Medicine, 1,3-ga Dongdaesindong, Seo-gu, Busan 602-715, Korea. Office: (82/51)240-5367, Fax: (82/51)253-4931 [email protected], [email protected]

1. Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 2017;34:70-81 2. Dong R, Dong Z, Liu H, Shi F, Du J. Prevalence, risk factors, outcomes, and treatment of obstructive sleep apnea in patients with cerebrovascular disease: a systemic review. J Stroke Cerebrovasc Dis 2018;27:1471-1480 3. Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, Quan SF, et al. Prospective study of obstructive sleep...