MedWire News: A type of treatment called continuous positive airway pressure reduces mortality risk in stroke patients who suffer from obstructive sleep apnoea, research shows.
Sleep apnoea is a condition in which repeated breathing interruptions occur during sleep. The most effective treatment for the disorder is continuous positive airway pressure, in which patients wear a device during sleep to keep their airways open.
Writing in the American Journal of Respiratory and Critical Care Medicine, Dr Miguel Ángel Martínez-García, from Requena General Hospital in Valencia, Spain, and team explain: “Obstructive sleep apnea is an independent risk factor for stroke, but little is known about the role of continuous positive airway pressure on mortality in patients with stroke.”
To investigate, the team studied 166 patients, aged an average of 73 years, who had suffered a stroke and who were subsequently diagnosed with sleep apnoea. Continuous positive airway pressure treatment was offered to the 96 patients with moderate-to-severe sleep apnoea.
Over the 5-year monitoring period, 49% of the patients died, and only 28 of the original 96 were considered to be fully compliant with continuous positive airway pressure treatment, with many unable to tolerate the treatment.
Patients with sleep apnoea who did not comply with continuous positive airway pressure treatment were nearly 1.6 times more likely to die over the study period than those without sleep apnoea. In contrast, patients with sleep apnoea who were able to tolerate continuous positive airway pressure treatment had a similar mortality risk to those without sleep apnoea.
The findings remained true after accounting for age, gender, smoking, the presence of other conditions and other variables, notes the team. Dr Martínez-García and colleagues conclude: “Our results suggest that patients with ischaemic stroke and moderate-to-severe obstructive sleep apnoea showed an increased mortality risk.
“Continuous positive airway pressure treatment treatment, although tolerated by only a small percentage of patients, is associated with a reduction in this excess risk and achieves a mortality [rate] similar to patients without obstructive sleep apnoea or with mild disease.”
They added that improving the comfort of positive airway pressure devices, as well as educating stoke patients with sleep apnoea about the benefits of continuous positive airway pressure, may help improve adherence to the treatment.
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