Effects of Continuous Positive Airway Pressure on Cognitive and Functional Outcome of Stroke Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial.

Autor:	Aaronson JA; Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed).; Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands., Hofman WF; Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands., van Bennekom CA; Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed)., van Bezeij T; Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed)., van den Aardweg JG; Department of Pulmonary Medicine, Medical Center Alkmaar, Alkmaar, Netherlands., Groet E; Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed)., Kylstra WA; Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed)., Schmand B; Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands.; Department of Neurology, Academic Medical Center, Amsterdam, Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2016 Apr 15; Vol. 12 (4), pp. 533-41. Date of Electronic Publication: 2016 Apr 15.
DOI:	10.5664/jcsm.5684
Abstrakt:	Study Objectives: Obstructive sleep apnea (OSA) in stroke patients is associated with worse functional and cognitive status during inpatient rehabilitation. We hypothesized that a four-week period of continuous positive airway pressure (CPAP) treatment would improve cognitive and functional outcomes. Methods: We performed a randomized controlled trial in stroke patients admitted to a neurorehabilitation unit. Patients were assigned to rehabilitation treatment as usual (control group) or to CPAP treatment (CPAP group). Primary outcomes were cognitive status measured by neuropsychological examination, and functional status measured by two neurological scales and a measure of activities of daily living (ADL). Secondary measures included sleepiness, sleep quality, fatigue, and mood. Tests were performed at baseline and after the four-week intervention period. Results: We randomly assigned 20 patients to the CPAP group and 16 patients to the control group. The average CPAP compliance was 2.5 hours per night. Patients in the CPAP group showed significantly greater improvement in the cognitive domains of attention and executive functioning than the control group. CPAP compliance was associated with greater improvement in cognitive functioning. CPAP did not result in measurable improvement on measures of neurological status or ADL, or on any of the secondary measures. Conclusions: CPAP treatment improves cognitive functioning of stroke patients with OSA. Commentary: A commentary on this article appears in this issue on page 467. (© 2016 American Academy of Sleep Medicine.)
Databáze:	MEDLINE
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