Positive airway pressure treatment for sleep-disordered breathing is rare during the first year after stroke: The BASIC project.

OBJECTIVE/BACKGROUND

Sleep-disordered breathing (SDB) is very common after ischemic stroke, and its treatment may have a positive impact on recovery from stroke and on secondary stroke prevention. This study sought to determine the prevalence of positive airway pressure (PAP) use after stroke.

PATIENTS/METHODS

Participants in the Brain Attack Surveillance in Corpus Christi (BASIC) project underwent a home sleep apnea test shortly after ischemic stroke. Demographics and co-morbidities were ascertained from the medical record. Self-reported PAP use (present vs absent) was assessed at 3, 6, and 12 months after stroke. Fisher exact tests and t-tests were used to compare PAP users versus non-users.

RESULTS

Of 328 participants who were found to have SDB after stroke, only 20 (6.1%) indicated using PAP at any point during the 12-month follow up period. High pre-stroke sleep apnea risk based on Berlin Questionnaire score, neck circumference, and co-morbid atrial fibrillation were associated with any self-reported PAP use; race/ethnicity, insurance status and other demographic variables were not associated with PAP use.

CONCLUSIONS

Only a small proportion of individuals with ischemic stroke and SDB received treatment with PAP during the initial year after stroke among participants in this population-based cohort study in Nueces County, Texas. Closing the substantial treatment gap for SDB after stroke might improve sleepiness and neurologic recovery.

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Dr. Schütz reports NIH support to the University of Michigan that is not related to the work being reported. She also reports contracts between University of Michigan and Apple Inc as well as Oura Health Oy. Dr. Lisabeth reports grants to the University of Michigan from the NIH for the work being reported. Madeline Kwicklis does not report any disclosures. Erin Case reports grants to the University of Michigan from the NIH for the work being reported. Dr. Chervin reports NIH support to the University of Michigan for the work being reported, financial support from UpToDate, consulting fees from Eli Lilly & Company made to the University of Michigan, patents or copyrighted material owned by the University of Michigan relevant to the diagnosis and treatment of sleep disorders. He also volunteers on the advisory board of The Pajama Program. Dr. Chervin reports non-financial support for serving as a treasurer and member of the board of directors of the International Pediatric Sleep Association. Dr. Brown reports grants to the University of Michigan from the NIH for the work being reported.