Sleep-disordered breathing after stroke: a randomised controlled trial of continuous positive airway pressure

Hsu, Chia Yang; Vennelle, Marjorie; Li, Hsueh‐Yu; Engleman, Heather M.; Dennis, Martin; Douglas, Neil J.

doi:10.1136/jnnp.2005.086686

Cited by 187 publications

(155 citation statements)

References 33 publications

Supporting

Mentioning

145

Contrasting

Unclassified

Order By: Relevance

“…Unfortunately, CPAP compliance has not been good in patients recovering from stroke, and beneficial effects have not been confirmed. 215 Tolerability and compliance with CPAP after stroke may be limited compared with patients without stroke. 216 In a prospective study of patients after acute ischemic stroke, Bassetti et al 203 found that only 15% of those with sleep apnea continued CPAP chronically.…”

Section: Treatment Of Osa: Effects On Strokementioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

Section: Treatment Of Osa: Effects On Strokementioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

“…The adherence to CPAP treatment seems even lower in stroke patients with SDB. With the exception of some studies performed in the rehabilitation poststroke setting and in selected patients showing higher adherence rates [10][11][12], reported CPAP compliance in the acute [13][14][15][16] and sub-acute stroke phase [12,[17][18][19] is around 25-50%. Most patients had stroke-related problems that caused non-compliance, including facial palsy inducing CPAP mask leaks [20].…”

Section: Introductionmentioning

confidence: 99%

Effect of transnasal insufflation on sleep disordered breathing in acute stroke: a preliminary study

et al. 2011

View full text Add to dashboard Cite

Background and Purpose Sleep disordered breathing (SDB) is frequent in acute stroke patients and is associated with early neurologic worsening and poor outcome. Although continuous positive airway pressure (CPAP) effectively treats SDB, compliance is low. The objective of the present study was to assess the tolerance and the efficacy of a continuous high-flow-rate air administered through an open nasal cannula (transnasal insufflation, TNI), a less-intrusive method, to treat SDB in acute stroke patients. Methods Ten patients (age, 56.8±10.7 years), with SDB ranging from moderate to severe (apnea-hypopnea index, AHI, >15/h of sleep) and on a standard sleep study at a mean of 4.8±3.7 days after ischemic stroke (range, 1-15 days), were selected. The night after, they underwent a second sleep study while receiving TNI (18 L/min).Results TNI was well tolerated by all patients. For the entire group, TNI decreased the AHI from 40.4±25.7 to 30.8± 25.7/h (p=0.001) and the oxygen desaturation index >3% from 40.7±28.4 to 31±22.5/h (p=0.02). All participants except one showed a decrease in AHI. The percentage of slow-wave sleep significantly increased with TNI from 16.7± 8.2% to 22.3±7.4% (p=0.01). There was also a trend toward a reduction in markers of sleep disruption (number of awakenings, arousal index). Conclusions TNI improves SDB indices, and possibly sleep parameters, in stroke patients. Although these changes are modest, our findings suggest that TNI is a viable treatment alternative to CPAP in patients with SDB in the acute phase of ischemic stroke.

show abstract

“…There are several reasons for poor compliance, including spontaneous improvement of SDB, lack of excessive daytime sleepiness in some patients, and motor (facial and bulbar palsy) and cognitive (confusional states, dementia, aphasia) deficits. Compliance has been reported to be as low as 25% to 50% in the acute 39,53,113,116,117 or subacute 69,74,114 stroke phase, whereas other groups reported rates as high as 70% in the rehabilitation setting. 56 This finding indicates the importance of CPAP acclimation by skilled respiratory therapists.…”

Section: Early Treatment Of Obstructive Sleep Apnea In Stroke Rehabilmentioning

confidence: 96%

“…Some studies found that CPAP improved 1 or more neurologic function outcomes, sleepiness, or mood, [13][14][15]47 whereas the others found no benefit of CPAP treatment in these areas. [113][114][115] However, the negative studies had small sample sizes and patients had low CPAP compliance, which may have affected the results.…”

Section: Early Treatment Of Obstructive Sleep Apnea In Stroke Rehabilmentioning

confidence: 99%

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Jafari

2017

Sleep Medicine Clinics

View full text Add to dashboard Cite

Sleep-disordered breathing after stroke: a randomised controlled trial of continuous positive airway pressure

Cited by 187 publications

References 33 publications

Sleep Apnea and Cardiovascular Disease

Sleep Apnea and Cardiovascular Disease

Effect of transnasal insufflation on sleep disordered breathing in acute stroke: a preliminary study

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Contact Info

Product

Resources

About