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Copyright ©ERS Journals Ltd 2001
Treatment of obstructive sleep apnoea with nasal continuous positive airway pressure in stroke
1 Dept of Respiratory and Sleep Medicine, Ruhrlandklinik, and 2 Dept of Neurology, Fachklinik Rhein/Ruhr, Essen, Germany
CORRESPONDENCE: T.E. Wessendorf, Ruhrlandklinik, Dept of Respiratory and Sleep Medicine, Tueschener Weg 40, D 45239, Essen, Germany. Fax: 49 2014334049
Keywords: compliance, nasal continuous positive airway pressure, obstructive sleep apnoea, stroke, treatment
Received: June 26, 2000
Accepted May 1, 2001
The study was supported by Landesversicherungsanstalt (LVA) Rheinprovinz, Düsseldorf, Germany, and ResMed, San Diego, CA, USA.
The prevalence of obstructive sleep apnoea (OSA) following stroke is high and OSA is associated with increased morbidity, mortality and poor functional outcome. Nasal continuous positive airway pressure (nCPAP) is the treatment of choice for OSA, but its effects in stroke patients are unknown.
The effectiveness and acceptance of treatment with nCPAP in 105 stroke patients with OSA, admitted to rehabilitation was prospectively investigated. Subjective wellbeing was measured with a visual analogue scale in 41 patients and 24-;h blood pressure was determined in 16 patients before and after 10 days of treatment. Differences were compared between patients who did and did not accept treatment.
There was an 80% reduction of respiratory events with concomitant increase in oxygen saturation and improvement in sleep architecture. No serious side-effects were noticed. Seventy-four patients (70.5%) continued treatment at home. Nonacceptance was associated with a lower functional status, as measured by the Barthel Index, and the presence of aphasia. Ten days after initiation of nCPAP, compliant users showed a clear improvement in wellbeing (differences in visual analogue scale (
Stroke patients with obstructive sleep apnoea can be treated effectively with nasal continuous positive airway pressure and show a similar improvement and primary acceptance to obstructive sleep apnoea patients without stroke. Continuous positive airway pressure acceptance is associated with improved wellbeing and decreased nocturnal blood pressure.
VAS) mean±sd 26±26 mm) versus noncompliant patients (VAS 2±25 mm, p=0.021). Only the compliant group had a reduction in mean nocturnal blood pressure (BP; –8±7.3 mmHg versus 0.8±8.4 mmHg, p=0.037).
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