Journal article
Positional therapy in ischemic stroke patients with obstructive sleep apnea
Sleep medicine, v 12(3), pp 262-266
2011
PMID: 21306949
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Obstructive sleep apnea (OSA) is common in stroke patients and is associated with poor functional outcome. The effects of positional therapy in ischemic stroke patients with OSA have not been investigated. We tested the hypothesis that ischemic stroke patients have less severe OSA during positional therapy that promotes nonsupine positioning.
We conducted a randomized, controlled, cross-over study. Sleep apnea screening studies were performed on two consecutive nights, using a portable respiratory monitoring system, on 18 subjects within the first 14
days of ischemic stroke. An apnea–hypopnea index (AHI) ⩾5 established the diagnosis of OSA. Subjects were randomized to positional therapy that included the use of a therapeutic pillow on either the first or second night. On the control night, subjects used the hospital pillow and were positioned
ad lib. Treatment effect on AHI was estimated using a repeated measures model.
All ischemic stroke subjects studied had OSA. The predominantly male group had a median age of 58
years, BMI of 29
kg/m
2, NIH Stroke Scale score of 3, and a median AHI on the nontherapeutic night of 39 (interquartile range: 21–54). Positional therapy reduced the amount of supine positioning by 36% (95% CI: 18–55% (
P
<
0.001)). The AHI was reduced by 19.5% (95% CI: 4.9–31.9% (
P
=
0.011)), when using positional therapy compared to sleeping
ad lib.
Positional therapy to avoid supine positioning modestly reduces sleep apnea severity after ischemic stroke, and may therefore improve outcomes.
Metrics
Details
- Title
- Positional therapy in ischemic stroke patients with obstructive sleep apnea
- Creators
- Anna Svatikova - Stroke Program, The Cardiovascular Center – Stroke Program, 1500 East Medical Center Drive, SPC#5855, Ann Arbor, MI 48109-5855, USARonald D Chervin - Sleep Disorders Center, University of Michigan, 1500 East Medical Center Drive, Med Inn C728, Ann Arbor, MI 48109-5845, USAJeffrey J Wing - Department of Biostatistics, M4164 SPH II, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USABrisa N Sanchez - Department of Biostatistics, M4164 SPH II, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USAErin M Migda - Stroke Program, The Cardiovascular Center – Stroke Program, 1500 East Medical Center Drive, SPC#5855, Ann Arbor, MI 48109-5855, USADevin L Brown - Stroke Program, The Cardiovascular Center – Stroke Program, 1500 East Medical Center Drive, SPC#5855, Ann Arbor, MI 48109-5855, USA
- Publication Details
- Sleep medicine, v 12(3), pp 262-266
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000289139900012
- Scopus ID
- 2-s2.0-79952187084
- Other Identifier
- 991014878038204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology