Early Sleep Apnea Detection and Treatment in Stroke Rehabilitation

Lisandro E. Olmos, Melania Ron, Valeria Grondona, Matias Gianella, Sebastian F. Ameriso

Abstract


Background: To assess whether the presence of obstructive sleep apnea is associated with changes in the motor, cognitive and functional outcomes in stroke patients. To investigate whether early intervention of obstructive sleep apnea impact the outcomes.

Methods: We performed overnight polysomnography in 25 patients admitted to the stroke rehabilitation unit. Those with an apnea/hypopnea index (AHI) > 10 per hour were randomized to standardized 30 day rehabilitation program with or without the addition of Bi level positive air pressure treatment at night. Cognitive, motor and functional status were assessed at baseline and at 30 days.

Results: The early Bi Level Possitive Air Pressure treatment in the obstructive sleep apnea group (n = 13) produced improvements of the motor scores compared to patients who did not receive it (n = 12). The group with BiPAP treatment showed significant improvements in the The Fugl-Meyer Upper Extremity Motor Assessment score (p = 0.05) and the The Fugl-Meyer Lower Extremity Motor Assessment score (p = 0.019) compared with the group without BiPAP treatment.

Conclusions: Early obstructive sleep apnea detection and treatment suggest that BiPAP treatment plays a role in motor recovery of stroke patients. The observations suggest that polysomnography evaluation looking for obstructive sleep apnea should be part of the standardized evaluation of stroke patients at admission to stroke rehabilitation facilities. 




doi:10.4021/jnr55w


Keywords


Stroke; Sleep apneas; Rehabilitation

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