Abstract | BACKGROUND AND PURPOSE: METHODS: All intervention patients received auto-CPAP for 2 nights, but only intervention patients with evidence of sleep apnea received auto-CPAP for the remainder of the 90-day period. Intervention patients received polysomnography at 90 days after TIA. Control patients received polysomnography at baseline and at 90 days. Acceptable auto-CPAP adherence was defined as >or=4 hours per night for >or=75% of nights. Vascular events included recurrent TIA, stroke, hospitalization for congestive heart failure, myocardial infarction, or death. RESULTS: We enrolled 70 acute TIA patients: 45 intervention and 25 control. The majority of patients had sleep apnea: 57% at baseline and 59% at 90 days. Among the 30 intervention patients with airflow obstruction, 12 (40%) had acceptable auto-CPAP adherence, 18 (60%) had some use, and none had no use. Three intervention patients (12%) had recurrent events compared with 1 (2%; P=0.13) control patient. The vascular event rate was highest among sleep apnea patients with no CPAP use: none, 16%; some, 5%; acceptable adherence 0% (P=0.08). CONCLUSIONS:
Sleep apnea is common among acute TIA patients. It appears feasible to provide auto-CPAP in the acute TIA period. Larger studies should evaluate whether a strategy of diagnosing and treating sleep apnea can reduce recurrent vascular events after TIA.
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Authors | Dawn M Bravata, John Concato, Terri Fried, Noshene Ranjbar, Tanesh Sadarangani, Vincent McClain, Frederick Struve, Lawrence Zygmunt, Herbert J Knight, Albert Lo, George B Richerson, Mark Gorman, Linda S Williams, Lawrence M Brass, Joseph Agostini, Vahid Mohsenin, Francoise Roux, H Klar Yaggi |
Journal | Stroke
(Stroke)
Vol. 41
Issue 7
Pg. 1464-70
(Jul 2010)
ISSN: 1524-4628 [Electronic] United States |
PMID | 20508184
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
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Topics |
- Aged
- Aged, 80 and over
- Continuous Positive Airway Pressure
(instrumentation, methods)
- Feasibility Studies
- Female
- Humans
- Ischemic Attack, Transient
(complications, therapy)
- Male
- Middle Aged
- Signal Processing, Computer-Assisted
(instrumentation)
- Sleep Apnea Syndromes
(diagnosis, etiology, therapy)
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