Patients with ischemic stroke and moderate to severe obstructive sleep apnea have been shown to be at an increased risk of mortality. Continuous positive airway pressure (CPAP) treatment is associated with a reduction in this risk in stroke patients with obstructive sleep apnea.
Researchers studied 166 patients (mean age 73.3) who had had an ischemic stroke and subsequently were diagnosed with sleep apnea in sleep study tests. CPAP treatment was offered to the 96 patients who scored above 20 on the apnea-hypopnea index, indicating moderate-to-severe obstructive sleep apnea. Each patient was followed for five years, reporting to the outpatient clinic and one, three and six months, then at six month intervals until the conclusion of the study. They were evaluated for general status, new cardiovascular events, CPAP adherence and death.
At the conclusion of the five year follow-up period, nearly half (48.8 percent) the original study group had died and only 28 of the original 96 were considered to be fully compliant with CPAP treatment. After adjusting for 13 potentially confounding variables, including age, gender, co-morbidities and current smoking, the researchers found that those with moderate to severe obstructive sleep apnea who had not complied with CPAP treatment had nearly 1.6 times the risk of death compared to patients who tolerated CPAP, whereas those with moderate-to-severe disease who had tolerated CPAP had similar risk of death than patients without sleep apnea or mild disease.
The study concluded that stroke patients with obstructive sleep apnea who undergo treatment with CPAP following their stroke could substantially reduce their risk of death.
References:
1. Miguel Ángel Martínez-García, et al. Continuous Positive Airway Pressure Treatment Reduces Mortality in Patients with Ischemic Stroke and Obstructive Sleep Apnea: A 5-Year Follow-up Study. American Journal of Respiratory and Critical Care Medicine. Am. J. Respir. Crit. Care Med., Jul 2009; 180: 36 – 41.
