Improving Stroke Recovery for Patients

Starting treatment for obstructive sleep apnea (OSA) immediately after a mini-stroke or a stroke has been shown to greatly improve many neurological symptoms including walking and speaking.  This is found in the article “Diagnosing and Treating Sleep Apnea in Patients with Acute Cerebrovascular Disease” in the Journal of the American Heart Association.

The lead researcher, Dawn Bravata, MD, from the Regenstrief Institute and Roudebush VA Medical Center stated, “We have shown, for the first time in a randomized controlled study, that for individuals who have had a stroke or a TIA—a transient ischemic attack, also known as a mini-stroke— the diagnosis and treatment of sleep apnea with CPAP therapy provides significant benefits, even greater than the benefits of tPA [tissue plasminogen activator], the FDA-approved drug treatment for stroke.  That’s a substantial clinical effect. The added good news for stroke patients is that CPAP has been used as a sleep apnea therapy for many years, and it has an excellent safety record.”

OSA is a common problem for patients who have had a stroke or a TIA.  Currently very few of these patients are currently diagnosed and/or treated for OSA while over 60% of them are suspected of having OSA.

CPAP and oral devices for OSA are safe to use as part of the stroke therapy.  Many patients are intolerant to using CPAP or just prefer oral devices.  The initial data from the study indicates that the sooner OSA is treated after a stroke or TIA, the more effective the treatment is.

Being diagnosed for OSA is simple in a sleep lab or at home.  A big question is this—would treatment for pre-existing OSA have prevented the stroke or TIA?? Studies need to be done!  Guidelines for stroke treatment recommend OSA testing, but studies indicate that it is not being done.