RT Journal Article SR Electronic T1 Positive airway pressure therapy for post-stroke sleep disordered breathing: a systematic review, meta-analysis and meta-regression JF European Respiratory Review JO EUROPEAN RESPIRATORY REVIEW FD European Respiratory Society SP 220169 DO 10.1183/16000617.0169-2022 VO 32 IS 167 A1 Zheng An Toh A1 Ling Jie Cheng A1 Xi Vivien Wu A1 Deidre Anne De Silva A1 Hui Xian Oh A1 Si Xian Ng A1 Hong-Gu He A1 Minna Pikkarainen YR 2023 UL http://err.ersjournals.com/content/32/167/220169.abstract 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