Document Detail


Treatment of obstructive sleep apnoea with nasal continuous positive airway pressure in stroke.
MedLine Citation:
PMID:  11716165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prevalence of obstructive sleep apnoea (OSA) following stroke is high and OSA is associated with increased morbidity, mortality and poor functional outcome. Nasal continuous positive airway pressure (nCPAP) is the treatment of choice for OSA, but its effects in stroke patients are unknown. The effectiveness and acceptance of treatment with nCPAP in 105 stroke patients with OSA, admitted to rehabilitation was prospectively investigated. Subjective wellbeing was measured with a visual analogue scale in 41 patients and 24-h blood pressure was determined in 16 patients before and after 10 days of treatment. Differences were compared between patients who did and did not accept treatment. There was an 80% reduction of respiratory events with concomitant increase in oxygen saturation and improvement in sleep architecture. No serious side-effects were noticed. Seventy-four patients (70.5%) continued treatment at home. Nonacceptance was associated with a lower functional status, as measured by the Barthel Index, and the presence of aphasia. Ten days after initiation of nCPAP, compliant users showed a clear improvement in wellbeing (differences in visual analogue scale (deltaVAS) mean+/-SD 26+/-26 mm) versus noncompliant patients (deltaVAS 2+/-25 mm, p=0.021). Only the compliant group had a reduction in mean nocturnal blood pressure (deltaBP; -8+/-7.3 mmHg versus 0.8+/-8.4 mmHg, p=0.037). Stroke patients with obstructive sleep apnoea can be treated effectively with nasal continuous positive airway pressure and show a similar improvement and primary acceptance to obstructive sleep apnoea patients without stroke. Continuous positive airway pressure acceptance is associated with improved wellbeing and decreased nocturnal blood pressure.
Authors:
T E Wessendorf; Y M Wang; A F Thilmann; U Sorgenfrei; N Konietzko; H Teschler
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The European respiratory journal     Volume:  18     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-11-21     Completed Date:  2002-03-12     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  623-9     Citation Subset:  IM    
Affiliation:
Dept Respiratory and Sleep Medicine, Ruhrlandklinik, Essen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Blood Pressure
Female
Home Care Services
Humans
Male
Middle Aged
Patient Compliance
Patient Satisfaction
Positive-Pressure Respiration*
Prospective Studies
Sleep Apnea, Obstructive / complications,  physiopathology,  therapy*
Stroke / complications*,  physiopathology
Treatment Refusal
Comments/Corrections
Comment In:
Eur Respir J. 2001 Oct;18(4):619-22   [PMID:  11716164 ]
Eur Respir J. 2002 Jun;19(6):1216-7; author reply 1217-9   [PMID:  12108881 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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