Gupta A, et al. - This study examined how continuous positive airway pressure (CPAP) treatment effects the prevention of new vascular events among patients with stroke and obstructive sleep apnea (OSA). Patients with stroke and OSA who used CPAP treatment had significantly better stroke outcomes and statistically nonsignificant favorable outcomes regarding recurrence of vascular events.

Methods

• The study cohort consisted of consecutive conscious patients presenting with first imaging-confirmed arterial stroke, 6 weeks or more after ictus.
• Enrollees underwent clinical and polysomnography (PSG) testing.
• Patients with an apnea-hypopnea index (AHI) of more than 15 events/hour were randomized between posttitration nightly CPAP treatment and non-CPAP (received best medical treatment) groups.
• Researchers assessed any new vascular events found at 3, 6, and 12 months follow-up from randomization as the primary outcome measure, and for the secondary outcome, clinical stroke outcomes (using the Barthel Index and modified Rankin scale) and neuropsychological parameters.

Results

• Out of the 679 patients with stroke who were screened, 116 reported for PSG, 83 had AHI > 15 events/hour, and 70 (34 in CPAP and 36 in non-CPAP) were randomized.
• During this research, 4 patients crossed over from the CPAP to the non-CPAP group.
• Both groups had similar age (mean age 53.41 ± 9.85 in CPAP vs 52.69 ± 13.23 years in non-CPAP, P=.81) and sex distribution (24 males in CPAP vs 33 males in non-CPAP, P=.79).
• One vascular event was seen at 12-month follow-up (3.33%) in the CPAP group and in the non-CPAP group (P=.23) 6 events (15%) were reported.
• Significantly more patients in the CPAP group compared to the non-CPAP group (53% vs 27%) experienced modified Rankin scale score improvement ≥ 1 at 12-month follow-up.