PT  - JOURNAL ARTICLE
AU  - Toh, Zheng An
AU  - Cheng, Ling Jie
AU  - Wu, Xi Vivien
AU  - De Silva, Deidre Anne
AU  - Oh, Hui Xian
AU  - Ng, Si Xian
AU  - He, Hong-Gu
AU  - Pikkarainen, Minna
TI  - Positive airway pressure therapy for post-stroke sleep disordered breathing: a systematic review, meta-analysis and meta-regression
AID  - 10.1183/16000617.0169-2022
DP  - 2023 Mar 31
TA  - European Respiratory Review
PG  - 220169
VI  - 32
IP  - 167
4099  - http://err.ersjournals.com/content/32/167/220169.short
4100  - http://err.ersjournals.com/content/32/167/220169.full
SO  - EUROPEAN RESPIRATORY REVIEW2023 Mar 31; 32
AB  - Background Sleep disordered breathing (SDB) is an under-recognised independent risk factor and a potential consequence of stroke. We systematically reviewed and meta-analysed the effectiveness of positive airway pressure (PAP) therapy in improving post-stroke outcomes.Methods We searched CENTRAL, Embase, PubMed, CINAHL, PsycINFO, Scopus, ProQuest, Web of Science and CNKI (China National Knowledge Infrastructure) for randomised controlled trials comparing PAP therapy against a control or placebo group. We evaluated the pooled effects of PAP therapy on recurrent vascular events, neurological deficit, cognition, functional independence, daytime sleepiness and depression using random effects meta-analyses.Results We identified 24 studies. Our meta-analyses showed that PAP therapy reduced recurrent vascular events (risk ratio 0.47, 95% CI 0.28–0.78), and showed significant beneficial effects on neurological deficit (Hedges’ g= −0.79, 95% CI −1.19– −0.39), cognition (g=0.85, 95% CI 0.04–1.65), functional independence (g=0.45, 95% CI 0.01–0.88) and daytime sleepiness (g= −0.96, 95% CI −1.56– −0.37). However, there was insignificant reduction in depression (g= −0.56, 95% CI −2.15–1.02). No publication bias was detected.Conclusions Post-stroke patients with SDB benefited from PAP therapy. Prospective trials are needed to determine the ideal initiation period and the minimum effective therapeutic dose.Positive airway pressure therapy has been shown to reduce recurrent vascular events and have significant beneficial effects on neurological deficit, cognition, functional independence and daytime sleepiness in post-stroke patients with SDB. https://bit.ly/3gXgLNy