Effect of CPAP Treatment of Sleep Apnea on Clinical Prognosis After Ischemic Stroke: An Observational Study.

TitleEffect of CPAP Treatment of Sleep Apnea on Clinical Prognosis After Ischemic Stroke: An Observational Study.
Publication TypeJournal Article
Year of Publication2019
AuthorsHaba-Rubio, J, Vujica, J, Franc, Y, Michel, P, Heinzer, R
JournalJournal of clinical sleep medicine
Volume15
Issue6
Pagination839-847
Date Published06/2019
DOI10.5664/jcsm.7832
ISSN1550-9397
Keywordscerebrovascular recurrence, Mortality, nasal continuous positive airway pressure, neurologic outcome, Polysomnography
Abstract

STUDY OBJECTIVES: To evaluate continuous positive airway pressure (CPAP) treatment in patients with moderate to severe sleep-disordered breathing (SDB) after an ischemic stroke.

METHODS: We identified patients included in the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) who underwent polysomnography after an ischemic stroke. We compared patients without significant SDB (apnea-hypopnea index [AHI] < 15 events/h: SDB-), with AHI ≥ 15 events/h who refused CPAP or with poor CPAP adherence (SDB+ CPAP-), and patients with SDB effectively treated by CPAP (SDB+ CPAP+).

RESULTS: We analyzed data from 101 patients (age 68.5 ± 11.1 years, 84.1% men). In multivariate analysis the SDB+ CPAP+ group was associated with a significant reduction of stroke recurrence and mortality (odds ratio 0.13, 95% confidence interval 0.00-0.86, = .031), whereas atrial fibrillation was independently associated with a higher risk (odds ratio 4.32, 95% confidence interval 1.51-12.33, = .006). Event-free survival analysis (stroke recurrence and death) after 2-year follow-up showed that those in the SDB+ CPAP+ group had significantly higher cardiovascular survival, and Cox proportion hazard model identified CPAP treatment as significantly associated with survival time ( = .025). The AHI and the National Institutes of Health Stroke Scale subacute score were independently associated with CPAP adherence among patients with SDB.

CONCLUSIONS: This observational study shows that CPAP treatment in stroke patients with moderate to severe SDB is associated with lower rates of stroke recurrence and death.

Alternate URL

https://www.ncbi.nlm.nih.gov/pubmed/31138378?dopt=Abstract

WOS ID (UT)

000471747600006

Alternate JournalJ Clin Sleep Med
Citation Key / SERVAL ID9698
Peer reviewRefereed
PubMed ID31138378
PubMed Central IDPMC6557650

                         

IUMSP | www.iumsp.ch
Institute of Social and Preventive Medicine
Route de la Corniche 10, 1010 Lausanne - Switzerland
+41 21 314 72 72 | iumsp@chuv.ch

Go to top