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the results of a randomized study suggest.
Obstructive sleep apnea is present in 50%-80% of patients with stroke, previous studies show, and its presence is associated with impaired function and cognition, delirium, and longer rehabilitation time, among other negative impacts, wrote Anupama Gupta, PhD, and her coauthors from the All India Institute of Medical Sciences, New Delhi, in the Journal of Clinical Sleep Medicine. Although multiple trials have shown a positive effect of CPAP on stroke recovery, relatively few investigations have looked specifically at whether the intervention prevents subsequent vascular events.
Patients’ clinical stroke outcomes were categorized in accordance with the Modified Rankin Scale (mRS), which is most widely used to assess disability and dependence outcomes among patients with stroke.
Significantly more patients who were treated with CPAP experienced an improvement in their mRS score by at least 1 point, when assessed at both 6 and 12 months following entrance into the study. Specifically, 53% (16) of patients in the CPAP group had an improvement of at least 1 point in their mRS score at 12 months, compared with 27% (11) of patients who did not use CPAP (P = .03).
“These differences are statistically significant, as well as clinically meaningful and relevant,” Dr. Gupta and her colleagues said in their report.
This finding was consistent with what researchers have seen in some earlier studies of stroke patients who used CPAP, the researchers wrote.
Additionally, CPAP-treated patients had fewer subsequent vascular events, compared with those who did not use CPAP, though the difference did not reach statistical significance. There was only one new vascular event (3.33%) in the CPAP group at 12-month follow-up, versus six events (15%) in the non-CPAP group (P = .23).
Nevertheless, the results provide more evidence for the potential benefit of CPAP in stroke patients with obstructive sleep apnea, the researchers noted.
“Our results indicate that new vascular events may be better prevented – and significantly more patients may make good stroke recovery – with CPAP treatment as compared to only best medical treatment,” Dr. Gupta and her colleagues wrote.
Before the study started, investigators determined that they would have needed 80 patients per arm for a power of 80%. A total of 679 patients were screened, but only 116 reported for polysomnography testing, and of those, 83 had at least moderate obstructive sleep apnea.
Due to a lack of CPAP devices, only 70 of those 83 patients made it all the way to randomization, investigators reported.
Dr. Gupta and her coauthors reported no conflicts of interest related to the study.
SOURCE: Gupta A et al. J Clin Sleep Med. 2018 Mar 30. pii:jc-17-00230.
the results of a randomized study suggest.
Obstructive sleep apnea is present in 50%-80% of patients with stroke, previous studies show, and its presence is associated with impaired function and cognition, delirium, and longer rehabilitation time, among other negative impacts, wrote Anupama Gupta, PhD, and her coauthors from the All India Institute of Medical Sciences, New Delhi, in the Journal of Clinical Sleep Medicine. Although multiple trials have shown a positive effect of CPAP on stroke recovery, relatively few investigations have looked specifically at whether the intervention prevents subsequent vascular events.
Patients’ clinical stroke outcomes were categorized in accordance with the Modified Rankin Scale (mRS), which is most widely used to assess disability and dependence outcomes among patients with stroke.
Significantly more patients who were treated with CPAP experienced an improvement in their mRS score by at least 1 point, when assessed at both 6 and 12 months following entrance into the study. Specifically, 53% (16) of patients in the CPAP group had an improvement of at least 1 point in their mRS score at 12 months, compared with 27% (11) of patients who did not use CPAP (P = .03).
“These differences are statistically significant, as well as clinically meaningful and relevant,” Dr. Gupta and her colleagues said in their report.
This finding was consistent with what researchers have seen in some earlier studies of stroke patients who used CPAP, the researchers wrote.
Additionally, CPAP-treated patients had fewer subsequent vascular events, compared with those who did not use CPAP, though the difference did not reach statistical significance. There was only one new vascular event (3.33%) in the CPAP group at 12-month follow-up, versus six events (15%) in the non-CPAP group (P = .23).
Nevertheless, the results provide more evidence for the potential benefit of CPAP in stroke patients with obstructive sleep apnea, the researchers noted.
“Our results indicate that new vascular events may be better prevented – and significantly more patients may make good stroke recovery – with CPAP treatment as compared to only best medical treatment,” Dr. Gupta and her colleagues wrote.
Before the study started, investigators determined that they would have needed 80 patients per arm for a power of 80%. A total of 679 patients were screened, but only 116 reported for polysomnography testing, and of those, 83 had at least moderate obstructive sleep apnea.
Due to a lack of CPAP devices, only 70 of those 83 patients made it all the way to randomization, investigators reported.
Dr. Gupta and her coauthors reported no conflicts of interest related to the study.
SOURCE: Gupta A et al. J Clin Sleep Med. 2018 Mar 30. pii:jc-17-00230.
the results of a randomized study suggest.
Obstructive sleep apnea is present in 50%-80% of patients with stroke, previous studies show, and its presence is associated with impaired function and cognition, delirium, and longer rehabilitation time, among other negative impacts, wrote Anupama Gupta, PhD, and her coauthors from the All India Institute of Medical Sciences, New Delhi, in the Journal of Clinical Sleep Medicine. Although multiple trials have shown a positive effect of CPAP on stroke recovery, relatively few investigations have looked specifically at whether the intervention prevents subsequent vascular events.
Patients’ clinical stroke outcomes were categorized in accordance with the Modified Rankin Scale (mRS), which is most widely used to assess disability and dependence outcomes among patients with stroke.
Significantly more patients who were treated with CPAP experienced an improvement in their mRS score by at least 1 point, when assessed at both 6 and 12 months following entrance into the study. Specifically, 53% (16) of patients in the CPAP group had an improvement of at least 1 point in their mRS score at 12 months, compared with 27% (11) of patients who did not use CPAP (P = .03).
“These differences are statistically significant, as well as clinically meaningful and relevant,” Dr. Gupta and her colleagues said in their report.
This finding was consistent with what researchers have seen in some earlier studies of stroke patients who used CPAP, the researchers wrote.
Additionally, CPAP-treated patients had fewer subsequent vascular events, compared with those who did not use CPAP, though the difference did not reach statistical significance. There was only one new vascular event (3.33%) in the CPAP group at 12-month follow-up, versus six events (15%) in the non-CPAP group (P = .23).
Nevertheless, the results provide more evidence for the potential benefit of CPAP in stroke patients with obstructive sleep apnea, the researchers noted.
“Our results indicate that new vascular events may be better prevented – and significantly more patients may make good stroke recovery – with CPAP treatment as compared to only best medical treatment,” Dr. Gupta and her colleagues wrote.
Before the study started, investigators determined that they would have needed 80 patients per arm for a power of 80%. A total of 679 patients were screened, but only 116 reported for polysomnography testing, and of those, 83 had at least moderate obstructive sleep apnea.
Due to a lack of CPAP devices, only 70 of those 83 patients made it all the way to randomization, investigators reported.
Dr. Gupta and her coauthors reported no conflicts of interest related to the study.
SOURCE: Gupta A et al. J Clin Sleep Med. 2018 Mar 30. pii:jc-17-00230.
FROM THE JOURNAL OF CLINICAL SLEEP MEDICINE
Key clinical point: Continuous positive airway pressure (CPAP) treatment may prevent vascular events in patients with stroke who have OSA.
Major finding: There was one vascular event (3.33%) at 12 months for CPAP-treated patients, versus six events (15%) in non-CPAP patients, though the difference was not significant (P = .23).
Study details: A single-blind, randomized, controlled trial including 70 patients with imaging-confirmed first arterial stroke and OSA.
Disclosures: The authors reported no conflicts of interest related to the study.
Source: Gupta A et al. J Clin Sleep Med. 2018 Mar 30. pii:jc-17-00230.