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Copyright ©ERS Journals Ltd 2001
Nasal continuous positive airway pressure in stroke patients with sleep apnoea: a randomized treatment study
1 Dept of Community Medicine and Rehabilitation, Geriatric Medicine, and 2 Dept of Public Health and Clinical Medicine, Respiratory Medicine, Umeå University, Umeå, Sweden
CORRESPONDENCE: O. Sandberg, Sunderby Hospital, Dept of Geriatric Medicine and Rehabilitation, SE-971 80, Luleå, Sweden. Fax: 46 920283695
Keywords: activities of daily living, cerebrovascular disorders, depression, nasal continuous positive airway pressure, randomized clinical trials, sleep apnoea syndromes
Received: August 3, 2000
Accepted May 10, 2001
This study received support in the form of grants from the Gun and Bertil Stohne Foundation, Borgerskapets in Umeå Foundation, the 1987 Foundation for Stroke Research, the Fund for Medical Research at Umeå University Hospital, the Foundation for Gamla Tjänarinnor, the Thureús Fund and the Loo and Hans Osterman Fund.
The authors have investigated whether treatment of sleep apnoea with nasal continuous positive airway pressure (nCPAP) improves depressive symptoms, personal activities of daily living (ADL), cognitive functioning and delirium in patients that have suffered a stroke.
Sixty-three patients consecutively admitted to a stroke rehabilitation unit 2–4 weeks after a stroke, with an apnoea/hypopnoea index
Compared to the control group, depressive symptoms (MADRS total score) improved in patients randomized to nCPAP treatment (p=0.004). No significant treatment effect was found with regard to delirium, MMSE or Barthel-ADL index. Delirium and low cognitive level (MMSE score) explained poor compliance with nCPAP.
Depressive symptoms are reduced through nasal continuous positive airway pressure treatment in patients with severe stroke and sleep apnoea. Compliance with nasal continuous positive airway pressure treatment is a problem in stroke patients, especially when delirium and severe cognitive impairment occur.
15, were randomized to either nCPAP treatment (n=33) or a control group (n=30). Four patients dropped out after randomization. Both groups were assessed at baseline and after 7 and 28 nights using the Montgomery-Åsberg Depression Rating Scale (MADRS), Barthel-ADL index, and the Mini-Mental State Examination (MMSE) scale.
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