Back to Search
Start Over
Expiratory Positive Airway Pressure for Sleep Apnea after Stroke: A Randomized, Crossover Trial
- Publication Year :
- 2016
- Publisher :
- American Academy of Sleep Medicine, 2016.
-
Abstract
- Obstructive sleep apnea (OSA) is common after stroke and predicts poor outcomes. Continuous positive airway pressure (CPAP) treats OSA but is generally poorly tolerated by stroke patients. We assessed whether nasal expiratory positive airway pressure (EPAP), an alternative to CPAP, may be an effective option after acute stroke.We conducted a randomized, controlled, two-period crossover study in which each acute ischemic stroke patient received 1 night of EPAP and 1 night without EPAP while OSA was monitored with a validated device, the Watch-PAT 200. Linear repeated- measures analyses were conducted. Sample size calculations indicated that 18 subjects would be required to detect a 10-point or larger average reduction in the apnea-hypopnea index (AHI, the primary outcome), with use of EPAP, with power ≥ 80% and α = 0.05.Among the 19 subjects who completed the protocol, nasal EPAP treatment was associated with a nonsignificant absolute difference in AHI of -5.73 events/h in the primary analysis (p = 0.183, 95% confidence interval -14.4, 2.97) and a nonsignificant absolute difference in AHI of -5.43 events/h in the subgroup of patients who used nasal EPAP for ≥ 3 h (p = 0.314, 95% confidence interval -16.6, 5.76).This study suggests that EPAP is not an effective alternative to CPAP in acute stroke patients with OSA. Further work is needed to identify other more effective alternatives.ClinicalTrials.gov, ID: NCT01703663.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_treatment
Polysomnography
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Sleep Apnea Syndromes
Medicine
Humans
cardiovascular diseases
Continuous positive airway pressure
Prospective Studies
Prospective cohort study
Stroke
Aged
Cross-Over Studies
medicine.diagnostic_test
Continuous Positive Airway Pressure
business.industry
Sleep apnea
Middle Aged
medicine.disease
Crossover study
Scientific Investigations
nervous system diseases
respiratory tract diseases
Obstructive sleep apnea
Expiratory positive airway pressure
Neurology
Anesthesia
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....e08011f01626f0d90dc7343c4c35d548