TY - JOUR T1 - CPAP treatment of sleep apnoea in the early phase of stroke: growing evidence of effectiveness JF - European Respiratory Journal JO - Eur Respir J SP - 997 LP - 999 DO - 10.1183/09031936.00182810 VL - 37 IS - 5 AU - P. Lévy AU - J-L. Pépin Y1 - 2011/05/01 UR - http://erj.ersjournals.com/content/37/5/997.abstract N2 - Sleep apnoea has been shown to be a cardiovascular risk factor 1, 2, presumably with a major role attributable to intermittent hypoxia 3, 4. Early reports have suggested a relationship between sleep-disordered breathing and stroke 5–8. The association between sleep apnoea and both prevalent and incident stroke has been further established in general population cohorts 9, 10. Specifically, the Wisconsin Sleep Cohort provided prospective evidence that sleep-disordered breathing precedes stroke and may contribute to the development of stroke 9. The prospective analysis of the Sleep Heart and Health Study also showed, in males <70 yrs of age, a strong adjusted association between ischaemic stroke and apnoea–hypopnoea index (AHI) in mild-to-moderate sleep apnoea 10. In this subgroup of middle-aged males, in the mild-to-moderate range of severity (AHI 5–25 events·h−1), each one-unit increase in AHI was estimated to increase stroke risk by 6%. It has also been shown that stroke and sleep apnoea are associated with increased mortality 8, 11. However, in a recent meta-analysis of 2,343 ischaemic or haemorrhagic stroke and transient ischaemic attack (TIA) patients, obstructive sleep apnoea (OSA) was very common, irrespective of the type of stroke or timing after stroke 12. Regardless of whether the studies were performed in acute stroke units or rehabilitation units, OSA was found in >50% of the stroke patients. Also, central events were limited to 7% of the total number of abnormal respiratory events during sleep. Consequently, as this association between sleep apnoea and stroke has been demonstrated, treating sleep-disordered breathing could be expected to be beneficial 13, 14 … ER -