Chest
Clinical InvestigationsContinuous Positive Airway Pressure Treatment in Sleep Apnea Prevents New Vascular Events After Ischemic Stroke
Section snippets
Patients
The present study selected all patients with ischemic stroke or TIA admitted to our center during the year 2002, and who had passed the acute phase of the neurologic event and were in a stable phase. Patients previously treated with CPAP were excluded. Patients with a new VE prior to conduction of the sleep diagnostic study were temporarily excluded until 2 months after the last cerebral vascular event. The study protocol was approved by the local ethics committee, and all patients gave
Results
Of 139 consecutive patients admitted to our center with a diagnosis of ischemic stroke or TIA, 110 patients survived for at least 2 months after the ischemic cerebrovascular episode. Of these patients, two who had received CPAP treatment previously were excluded. Twelve patients either failed to give consent or did not report to the sleep study, and 3 patients could not be contacted following the acute episode. The diagnostic polygraphic study was carried out after 64 ± 11 days in 95 patients,
Discussion
According to our results, CPAP treatment protected against the appearance of a new VE after ischemic stroke or TIA in patients with an AHI ≥ 20 following stabilization of the neurologic process, without inducing changes in the neurologic recovery parameters, although tolerance of the treatment was low. Some studies have analyzed the course of patients with ischemic stroke in relation to the incidence of SAHS after stabilization of the ischemic event. Good et al31 reported poorer neurologic
References (37)
- et al.
Prevalencia de trastornos respiratorios durante el sueño en pacientes con ictus isquémico agudo: influencia del momento de aparición del ictus
Arch Bronconeumol
(2004) - et al.
Classification and natural history of clinically identifiable subtypes of cerebral infarction: Oxfordshire Community Stroke Project
Lancet
(1991) - et al.
Validación de la versión española del test de somnolencia Epworth en pacientes con síndrome de apnea del sueño
Arch Bronconeumol
(1999) - et al.
Predicting effective continuous positive pressure
Chest
(2000) - et al.
Prevalence of sleep-disordered breathing and continuous positive airway pressure compliance: results in Chinese patients with first-ever ischemic stroke
Chest
(2002) - et al.
Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnoea syndrome
Am J Med
(2000) - et al.
Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study
Am J Respir Crit Care Med
(2001) - et al.
Obstructive sleep apnea: implications for cardiac and vascular disease
JAMA
(2003) - et al.
An independent association between obstructive sleep apnoea and coronary artery disease
Eur Respir J
(1999) - et al.
Obstructive sleep apnea and the recurrence of atrial fibrillation
Circulation
(2003)
Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure
Am J Respir Crit Care Med
Time course of sleep-related breathing disorders in first-ever ischemic stroke or transient ischemic attack
Am J Respir Crit Care Med
Investigating the relationship between stroke and obstructive sleep apnea
Stroke
Snoring, sleep apnoea and stroke: chicken or scrambled egg?
Q J Med
Prospective study of the association between sleep-disordered breathing and hypertension
N Engl J Med
Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea
Circulation
Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome
Am J Respir Crit Care Med
Nocturnal continuous positive airway pressure decreases daytime sympathetic traffic in obstructive sleep apnea
Circulation
Cited by (193)
Role of Screening in Sleep Disordered Breathing (SDB)
2021, Encyclopedia of Respiratory Medicine, Second EditionWhen a private community neurology practice executes home sleep apnea testing: benefits identified and lessons learned in a retrospective observational study
2018, Sleep HealthCitation Excerpt :Obstructive sleep apnea (OSA) frequently results in memory and concentration issues, changes in mood, headaches, insomnia, daytime sleepiness, weight gain, and increased risk of atrial fibrillation, which can negatively impact patients with neurological disease while predisposing others to new neurological diseases such as stroke. Moreover, inadequately treated OSA can negatively affect optimal management of some neurological conditions, for instance, reduced poststroke functional recovery13,14 and increased risk of future vascular events.15 As such, the American Heart Association now lists OSA as a primary risk factor for stroke.16
Study of association of severity of sleep disordered breathing and functional outcome in stroke patients
2017, Sleep MedicineCitation Excerpt :Stroke patients with SDB may be candidates for treatment of the underlying SDB with the aim to prevent recurrence and other vascular events. A few recent studies have demonstrated that CPAP treatment in patients with stroke and SDB has improved subjective well-being, reduced depressive symptoms, and lowered the incidence of new vascular events and mortality [32–34]. A recent randomized controlled trial has shown that CPAP treatment improves cognitive functioning in stroke patients with OSA [35].
Rehabilitation of Cardiovascular Disorders and Sleep Apnea
2017, Sleep Medicine ClinicsObstructive Sleep Apnea and Stroke: Determining the Mechanisms Behind their Association and Treatment Options
2024, Translational Stroke Research
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).