Breaking News
February 24, 2019 - Novel MRI sensor can peer deep into the brain to detect intracellular calcium activity
February 24, 2019 - AHA News: Diabetes Remains Dangerous Despite Modern Medicine
February 24, 2019 - Dup15q syndrome – Genetics Home Reference
February 24, 2019 - Could ‘Cardio-obstetrics’ curb rise in pregnancy-related deaths?
February 24, 2019 - Using computer model to visualize brain’s internal valuation system
February 24, 2019 - Study reveals insights into how the brain learns new locomotor patterns
February 24, 2019 - Depression Screening: MedlinePlus Lab Test Information
February 24, 2019 - Researchers discover a weakness in a rare cancer that could be exploited with drugs
February 23, 2019 - U.S.-based patient advocacy organizations received majority of pharma donations, finds study
February 23, 2019 - UCL and AIIMS collaborates to increase academic and student exchange
February 23, 2019 - Mechanism behind how diabetes causes muscle loss revealed
February 23, 2019 - Hepatocellular carcinoma diagnosis, prognosis and treatment may improve by identifying a protein
February 23, 2019 - The American Heart Association issues new reference toolkit for healthcare providers
February 23, 2019 - Studies explore physiological dangers that climate change will have on animal life
February 23, 2019 - Penn study reveals increase in health-related internet searches before ER visits
February 23, 2019 - Intensive therapy during early stages of MS leads to better long-term outcomes
February 23, 2019 - Prenatal Fluconazole Exposure Increases Neonatal Risks
February 23, 2019 - Mental Health Screening: MedlinePlus Lab Test Information
February 23, 2019 - Study suggests birth mechanics are part of the process that leads to autism
February 23, 2019 - Unhealthy diet linked to poor mental health
February 23, 2019 - Study gives a snapshot of crocodile evolution
February 23, 2019 - Research finds steep rise in self-poisonings among young people
February 23, 2019 - American Gastroenterological Association announces “AGA Future Leaders Program”
February 23, 2019 - Scientists uncover new mechanisms regulating neural stem cells
February 23, 2019 - Combinations of certain insecticides turn out to be lethal for honeybees
February 23, 2019 - AHA News: Why Are Black Women at Higher Risk of Dying From Pregnancy Complications?
February 23, 2019 - NIMH » Anxiety Disorders
February 23, 2019 - Autistic people urgently need access to tailored mental health support
February 23, 2019 - Newly designed molecule could benefit people with Friedrich’s Ataxia
February 23, 2019 - Chinese CRISPR twins may have better cognition and memory
February 23, 2019 - Study finds new genetic clues associated with asthma in African ancestry populations
February 23, 2019 - Fetal signaling pathways may offer future opportunities to treat lung damage
February 23, 2019 - Early-stage osteoarthritis drug wins prestigious innovation award
February 23, 2019 - Researchers report positive findings with dasotraline for ADHD in children ages 6-12
February 23, 2019 - News study reanalyzes the effects of noncaloric sweeteners on gut microbiota
February 23, 2019 - New device allows scientists to reproduce blow effects on the heart in lab
February 23, 2019 - Paying more attention to antibiotic dosing could improve clinical outcomes for CF patients
February 23, 2019 - Big-data analysis finds new link between popular arthritis drug and heart valve calcification
February 23, 2019 - Holy herb identified as a potential treatment for Alzheimer’s disease
February 23, 2019 - New technology platform digitally counts growth factors in single cells
February 23, 2019 - Physicians still remain at higher risk for burnout compared to other professionals
February 23, 2019 - Surgery and other treatments offer viable options for adult scoliosis
February 23, 2019 - Reduced antibody adaptability may make the elderly more vulnerable to influenza
February 23, 2019 - Researchers find increased rates of CRC screening in Kentucky after Medicaid expansion
February 23, 2019 - Neighborhood income, education associated with risk of disability progression in MS patients
February 23, 2019 - Endocrine Society opposes new rule that restricts access to Title X Family Planning Program
February 23, 2019 - 2019 guidelines for management of patients with atrial fibrillation
February 23, 2019 - Surprise rheumatoid arthritis discovery points to new treatment for joint inflammation
February 23, 2019 - A just-right fix for a tiny heart
February 23, 2019 - UMass Amherst scientist explores role of citrus peel in decreasing gut inflammation
February 23, 2019 - Owlstone Medical and Shanghai Renji Hospital collaborate to initiate breath biopsy lung cancer trial
February 23, 2019 - AMSBIO’s comprehensive portfolio of knock-out cell lines and lysates
February 23, 2019 - New app reliably determines physicians’ skills in forming accurate, efficient diagnoses
February 23, 2019 - Peripheral nerve injury can trigger the onset and spread of ALS, shows study
February 23, 2019 - Researchers uncover mechanisms that prevent tooth replacement in mice
February 23, 2019 - Once-a-day capsule offers new way to reduce symptoms of chronic breathlessness
February 23, 2019 - FDA Adds Boxed Warning for Increased Risk of Death with Gout Medicine Uloric (febuxostat)
February 23, 2019 - Phone-based intervention aids rheumatoid arthritis care
February 23, 2019 - Opioid epidemic makes eastern inroads and targets African-Americans
February 23, 2019 - New identified biomarker predicts patients who might benefit from HER2-targeted agents
February 23, 2019 - Study offers new insights into mechanisms of changes in erythrocytes under stress
February 23, 2019 - Antipsychotic polypharmacy may be beneficial for schizophrenia patients
February 23, 2019 - Researchers investigate how marijuana and tobacco co-use affects quit attempts by smokers
February 23, 2019 - Patients with diabetes mellitus have high risk of stable ischemic heart disease
February 23, 2019 - Transparency on healthcare prices played key role in Arizona health system’s turnaround
February 23, 2019 - A comprehensive, multinational review of peppers around the world
February 23, 2019 - Study finds modest decrease in burnout among physicians
February 23, 2019 - A simple change can drastically reduce unnecessary tests for urinary tract infections
February 23, 2019 - Deep Learning-Enhanced Device Detects Diabetic Retinopathy
February 23, 2019 - Researchers discover new binding partner for amyloid precursor protein
February 23, 2019 - Modest decrease seen in burnout among physicians, researchers say | News Center
February 23, 2019 - Transplanting bone marrow of young mice into old mice prevents cognitive decline
February 23, 2019 - Mogrify to accelerate novel IP and cell therapies using $3.7m USD funding
February 23, 2019 - Johns Hopkins study describes cells that may help speed bone repair
February 23, 2019 - Scientists demonstrate influence of food odors on proteostasis
February 23, 2019 - Researchers unlock the secret behind reproduction of fish called ‘Mary’
February 23, 2019 - Acupuncture Could Help Ease Menopausal Symptoms
February 23, 2019 - Researchers use AI to detect early signs of Alzheimer’s
February 23, 2019 - On recovery, vulnerability and ritual: An exhibit in white | News Center
February 23, 2019 - Memory Stored in Unexpected Region of the Brain
Treating sleep apnea greatly improves stroke patients’ neurological and functional recovery

Treating sleep apnea greatly improves stroke patients’ neurological and functional recovery

image_pdfDownload PDFimage_print

A large study has found that commencing treatment for sleep apnea as soon as possible after a stroke or a mini-stroke significantly improves speech impairment and other neurological symptoms as well as walking and other physical functioning.

“We have shown, for the first time in a randomized controlled study, that for individuals who have had a stroke or a TIA—a Transient Ischemic Attack, also known as a mini-stroke—the diagnosis and treatment of sleep apnea with CPAP [Continuous Positive Airway Pressure] therapy provides significant benefits, even greater than the benefits of tPA [tissue plasminogen activator], the FDA-approved drug treatment for stroke,” said Regenstrief Institute and Roudebush VA Medical Center research scientist Dawn Bravata, M.D., who led the study.

“That’s a substantial clinical effect. The added good news for stroke patients is that CPAP has been used as a sleep apnea therapy for many years, and it has an excellent safety record,” she said.

“Diagnosing and Treating Sleep Apnea in Patients with Acute Cerebrovascular Disease” is published online ahead of print in the Journal of the American Heart Association.

Stroke is the fifth leading cause of death in the United States. According to the National Institute of Neurological Disorders and Stroke, more than 780,000 strokes occur annually in the U.S.

TIAs produce symptoms similar to those of a stroke, but typically last only a few minutes and usually cause no permanent damage. An estimated one-quarter of individuals who experience a TIA will eventually have a stroke, with about half of these strokes occurring within 12 months after the mini-stroke.

Sleep apnea is common among patients with stroke or TIA. Although few stroke patients are currently diagnosed and treated, approximately two out of three are thought to have sleep apnea, a disorder in which breathing during sleep is irregular. Sleep apnea may cause low oxygen levels, high blood pressure, and heart rhythm issues.

CPAP for sleep apnea can be used safely in addition to other stroke therapies, most of which have known adverse effects. For example, tPA, a clot buster, can induce non-trivial bleeding.

The new study, followed individuals who had strokes or TIAs for up to one year after the event. Two-thirds of the 252 study participants, 41 percent of whom were female and 36 percent of whom were black, were able to use CPAP effectively.

“Preliminary data suggests the sooner you treat sleep apnea in stroke patients with CPAP, the more potent the effect of that treatment,” said Dr. Bravata. “Usually diagnosing sleep apnea is an outpatient service, but we need to make sleep testing acutely available to stroke and TIA patients in the hospital as part of their work-up, just as we do brain imaging, lab testing and cardiac monitoring as part of the initial stroke/TIA evaluation.

“This will require changes in sleep medicine services by healthcare systems as they care for stroke patients; but the benefits of acute sleep apnea management are now clear,” Dr. Bravata said.

Patients in the study were from five hospitals in two states. They were randomized to a control group (usual care) without sleep apnea treatment or to one of two intervention groups (standard or enhanced care), both of which included sleep apnea diagnosis and treatment.

National stroke guidelines recommend testing for sleep apnea, however, past observational studies have shown that it is not being done. Dr. Bravata believes that with the results of large studies like this one, diagnosing and treating sleep apnea post-stroke acutely will become a routine part of standard practice.


Explore further:
Sleep apnea after stroke heightens risk of another stroke; death

More information:
Journal of the American Heart Association (2018). DOI: 10.1161/JAHA.118.008841

Journal reference:
Journal of the American Heart Association

Provided by:
Regenstrief Institute

Tagged with:

About author

Related Articles