Breaking News
September 24, 2018 - King’s commemorates opening of new NMR facility with one-day symposium
September 24, 2018 - Eisai receives approval for partial label change of DC Bead device for transcatheter arterial embolization
September 24, 2018 - High-resolution genomic map gives scientists unprecedented view of brain development
September 24, 2018 - Alexion announces positive results from Phase 3 PREVENT study of Soliris in patients with NMOSD
September 24, 2018 - First evaluation of benefits, harms of Alzheimer’s screening for family members of older adults
September 24, 2018 - Children of mothers using cannabis may start using it at an earlier age, finds study
September 24, 2018 - Most patients who underwent transcatheter valve replacement experience prosthesis-patient mismatch
September 24, 2018 - New study provides basis for Air Canada to change its facial hair policy for aircrew
September 24, 2018 - Infant walkers lead to thousands of emergency visits for babies
September 24, 2018 - Genes predicting person’s height may provide clues about causes of varicose veins
September 24, 2018 - EPA Plan Will Maintain Carbon Emissions From Power Plants
September 24, 2018 - Characterizing pig hippocampus could improve translational neuroscience
September 24, 2018 - Element3 Health reports social and mental engagement play key role in overall health
September 24, 2018 - Paralympic medalists support Fight for Sight’s unique virtual event
September 24, 2018 - ADCETRIS drug receives approval in Japan as frontline treatment option for Hodgkin lymphoma
September 24, 2018 - Public awareness of urological conditions found to be alarmingly low across Europe
September 24, 2018 - Fitter Folks Suffer Milder Strokes: Study
September 24, 2018 - Novel botulinum toxin compound relieves chronic pain
September 24, 2018 - CHMP recommends approval of Gilenya for treatment of multiple sclerosis in children, adolescents
September 24, 2018 - National Friendly’s private medical insurance is a hit with women living in the South East
September 24, 2018 - Academics receive prestigious awards for achievements in blood pressure research
September 24, 2018 - Obese pregnant women can restrict weight gain safely with proper nutrition guidance
September 24, 2018 - CHMP adopts positive opinion of Takeda’s ALUNBRIG for treatment of ALK+ non-small cell lung cancer
September 24, 2018 - China NMPA approves LENVIMA for treatment of unresectable hepatocellular carcinoma
September 24, 2018 - A new approach for finding Alzheimer’s treatments
September 24, 2018 - USC research uncovers previously unknown genetic risk factor for dementia
September 24, 2018 - Study examining mental health among students finds significant disparities in treatment across race
September 24, 2018 - Breakthrough discovery paves way for future test to identify drowsy drivers
September 24, 2018 - Transcatheter mitral-valve repair in patients with heart failure
September 24, 2018 - Study opens new avenues for treatment of Laing distal myopathy
September 24, 2018 - Stroke Facts | cdc.gov
September 24, 2018 - Sarcolipin tricks muscle cells into using more energy, burning fat
September 24, 2018 - Enrollment in opioid controlled substance agreement reduces primary care visits
September 24, 2018 - UTA researchers patent new smart seat cushion technology that helps prevent painful ulcers
September 24, 2018 - Second HPV-Related Primary Cancers Common in Survivors
September 24, 2018 - How a virus destabilizes the genome
September 24, 2018 - Old letters provide insight into Spanish flu pandemic horror
September 23, 2018 - Smart textile-based soft robotic exosuit helps wearers save energy and traverse difficult terrain
September 23, 2018 - New research hub to drive radical change in development and manufacturing of vaccines
September 23, 2018 - AHA: For Hispanics, Neighborhood May Be Key Factor in Heart Disease Risk
September 23, 2018 - Excessive airway nerves tied to more severe asthma symptoms, study finds
September 23, 2018 - Study highlights need to remain vigilant in maintaining key infection control processes
September 23, 2018 - Novel therapeutic strategy for blood vessel related disorders, such as cancer and retinopathy
September 23, 2018 - New naturally occurring antibiotic found effective against Mycobacterium tuberculosis
September 23, 2018 - First-in-human phase 0 study shows clinically-relevant activity of new drug in glioblastoma
September 23, 2018 - Removing tobacco product display from shops reduced number of children buying cigarettes
September 23, 2018 - Random fraction of specialized immune cells leads the charge in battling invaders
September 23, 2018 - Few minutes of sprinting exercise may be as effective as longer exercise sessions
September 23, 2018 - Researchers use neutrons to make first direct observations of water in lipid bilayers
September 23, 2018 - Researchers demonstrate pre-clinical success for universal flu vaccine in new paper
September 23, 2018 - Study reveals surprising gaps in some HIV medical providers’ knowledge of ACA
September 23, 2018 - Oxehealth secures European medical device accreditation for vital signs measurement software
September 23, 2018 - HTN Tx Intensification Common Upon Discharge in U.S. Vets
September 23, 2018 - Fibre can strengthen the intestinal barrier
September 23, 2018 - New platform examines infectious pathogens that may spread from animals to humans
September 23, 2018 - Demographers create detailed color map of population aging in Europe
September 23, 2018 - New type of fatty acid can slow down overreactive immune system
September 23, 2018 - Innovative procedure could provide breakthrough in treating early-stage lung cancer
September 23, 2018 - Research finds drop in number of measles cases in the EU/EEA since March 2018
September 23, 2018 - Researchers acquire new insights into DNA polymerases
September 23, 2018 - Alzheimer’s diagnosis might become simpler with new brain imaging method
September 23, 2018 - Reports Warn of Growing Opioid Crisis Among Seniors
September 23, 2018 - Researchers unravel why people with HIV suffer from more neurologic diseases
September 23, 2018 - Human brain structured to make best possible decision with limited resources
September 23, 2018 - KHN’s ‘What the Health?’ Health on the hill
September 23, 2018 - Bad air and inadequate data prove an unhealthy mix
September 23, 2018 - Regular bedtime and wake time important for heart, metabolic health even among adults
September 23, 2018 - HIV and a tale of a few cities
September 23, 2018 - NIH launches clinical trial to test infusions of combination antibodies in people with HIV
September 23, 2018 - Researchers develop new system to detect consumption of synthetic cannabinoids
September 23, 2018 - Vax-Hub to influenze radical change in development and manufacturing of vaccines
September 23, 2018 - People who have slept lesser than seven hours have higher risks of car crashes
September 23, 2018 - an ancient art may work best to prevent falls in old age
September 23, 2018 - Consumption of foods with lower nutritional quality related to increased cancer risk
September 23, 2018 - Patient Health Information Often Shared Electronically
September 23, 2018 - Can machine learning bring more humanity to health care?
September 23, 2018 - Body organs undergo structural changes in response to diet
September 23, 2018 - Genetic polymorphisms linked with muscle injury and stiffness
September 23, 2018 - As states try to rein in drug spending, feds slap down one bold Medicaid move
September 22, 2018 - Why Eczema Is Tougher to Treat for Black Patients
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