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Sleep-disordered breathing after stroke: a randomised controlled trial of continuous positive airway pressure
- Source :
- Hsu, C-Y, Vennelle, M, Li, H-Y, Engleman, H M, Dennis, M S & Douglas, N J 2006, ' Sleep-disordered breathing after stroke : a randomised controlled trial of continuous positive airway pressure ', Journal of Neurology, Neurosurgery & Psychiatry, vol. 77, no. 10, pp. 1143-9 . https://doi.org/10.1136/jnnp.2005.086686
- Publication Year :
- 2006
-
Abstract
- BackgroundSleep‐disordered breathing (SDB) is common after stroke, but it is unclear whether it should be treated.ObjectiveTo conduct a randomised controlled trial of continuous positive airway pressure (CPAP) after stroke.MethodsPatients with stroke with [gt-or-equal, slanted]30 apnoeas and hypopnoeas per hour ((A+H)/h) with predominant obstructive sleep apnoea or hypopnoea were randomised to either CPAP treatment or conservative treatment for 8 weeks. Outcomes were measured blind to treatment allocation at 8 weeks and 6 months after the stroke. The primary outcome was physical function on the Nottingham Extended Activities of Daily Living Scale.ResultsOf 658 patients with stroke screened, only 71 (10.7%) were eligible and consented to a sleep study 14–19 days after stroke. 66 patients completed the sleep study (21 women; mean age 72 years), 33 (50%) had [gt-or-equal, slanted]30 (A+H)/h that were predominantly obstructive. 15 were randomised to CPAP treatment and 15 to conventional treatment. Despite intensive efforts, objective use of CPAP was poor, averaging 1.4 h a night. CPAP treatment resulted in no significant improvements (p>0.1) in the primary outcome or in neurological function or sleepiness, and in poorer health status on some measures.ConclusionsThis trial showed no benefit from CPAP treatment, the relevance of the observed detrimental effects is questionable. Even in our highly selected patients with stroke, use of CPAP was poor. At present, CPAP treatment should be advocated for patients with stroke only if they have symptoms of SDB.
- Subjects :
- Male
Paper
medicine.medical_specialty
Activities of daily living
medicine.medical_treatment
Positive pressure
law.invention
Cognition
Sleep Apnea Syndromes
Randomized controlled trial
law
Activities of Daily Living
medicine
Humans
Continuous positive airway pressure
Sleep study
Stroke
Fatigue
Aged
Continuous Positive Airway Pressure
Vascular disease
business.industry
medicine.disease
nervous system diseases
respiratory tract diseases
Psychiatry and Mental health
Affect
Treatment Outcome
Anesthesia
Physical therapy
Breathing
Surgery
Female
Neurology (clinical)
business
Subjects
Details
- ISSN :
- 1468330X
- Volume :
- 77
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of neurology, neurosurgery, and psychiatry
- Accession number :
- edsair.doi.dedup.....0f83f5bb3ca32aff214a8d6a18cc62d8