Stroke and CPAP Outcome Study 2
| Status: | Completed |
|---|---|
| Conditions: | Insomnia Sleep Studies, Neurology, Pulmonary |
| Therapuetic Areas: | Neurology, Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/7/2018 |
| Start Date: | June 2016 |
| End Date: | July 2018 |
Maximizing Use of Continuous Positive Airway Pressure in Stroke Rehabilitation Patients With Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is associated with impaired stroke recovery. Treatment with
continuous positive airway pressure (CPAP) may prevent this but is limited by poor adherence.
In this study, the investigators will enroll eligible stroke patients undergoing inpatient
rehabilitation into an intensive CPAP adherence protocol (iCAP) with an aim to increase
tolerance and adherence to auto-titrating CPAP (APAP). The iCAP will include patient
education and encouragement, device adjustments, close monitoring of adherence and a 3-night
run-in period of APAP to identify those patients who 1. have OSA and 2. have APAP tolerance.
If both criteria are met, APAP treatment with iCAP will continue during the rehabilitation
stay and over a 3-month period. The goal of the intervention is to achieve 50% of subjects
meeting APAP adherence (an average ≥ 4 hours per night) over the 3-month treatment period.
The investigators will evaluate if demographic, co-morbid or stroke-specific factors predict
APAP adherence and assess the relationship between APAP adherence and neurological recovery.
Successful completion of the project will establish the feasibility of a definitive trial
assessing the ability of APAP to improve stroke recovery in the short-term and reduce the
risk of recurrent stroke in the long-term.
continuous positive airway pressure (CPAP) may prevent this but is limited by poor adherence.
In this study, the investigators will enroll eligible stroke patients undergoing inpatient
rehabilitation into an intensive CPAP adherence protocol (iCAP) with an aim to increase
tolerance and adherence to auto-titrating CPAP (APAP). The iCAP will include patient
education and encouragement, device adjustments, close monitoring of adherence and a 3-night
run-in period of APAP to identify those patients who 1. have OSA and 2. have APAP tolerance.
If both criteria are met, APAP treatment with iCAP will continue during the rehabilitation
stay and over a 3-month period. The goal of the intervention is to achieve 50% of subjects
meeting APAP adherence (an average ≥ 4 hours per night) over the 3-month treatment period.
The investigators will evaluate if demographic, co-morbid or stroke-specific factors predict
APAP adherence and assess the relationship between APAP adherence and neurological recovery.
Successful completion of the project will establish the feasibility of a definitive trial
assessing the ability of APAP to improve stroke recovery in the short-term and reduce the
risk of recurrent stroke in the long-term.
Inclusion Criteria:
- Adult patients admitted after acute ischemic or hemorrhagic stroke to an inpatient
rehabilitation units
Exclusion Criteria:
- The investigators will exclude participants if: their stroke was a subarachnoid
hemorrhage or due to a secondary cause (vascular malformation, vasculitis, brain
tumor, head trauma, or predisposition to bleeding); they have active CPAP use,
advanced chronic lung disease requiring supplemental oxygen, heart failure (NYHA class
III or IV); or they needed a nasogastric feeding tube.
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Univ of Washington Founded in 1861 by a private gift of 10 acres in what...
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