Improvement of Cognitive Function after Continuous Positive Airway Pressure Treatment for Subacute Stroke Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial
Improvement of Cognitive Function after Continuous Positive Airway Pressure Treatment for Subacute Stroke Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial
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DOI：
10.3390/brainsci9100252
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发表时间：
2019-10-01
期刊：
影响因子：
3.3
通讯作者：
Jee, Sungju
中科院分区：
文献类型：
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作者：
Kim, Howook;Im, Soobin;Jee, Sungju
背景：阻塞性睡眠呼吸暂停（OSA）是卒中后常见的并发症。关于持续气道正压通气（CPAP）治疗中风后OSA的各种研究已经发表。然而，没有来自韩国和亚洲的研究。目前韩国的研究旨在确定患有睡眠障碍（尤其是阻塞性睡眠呼吸暂停综合症）的中风患者住院康复期间的CPAP治疗是否能改善功能、认知、睡眠质量和白天嗜睡。方法：这项单盲随机对照研究纳入了2017年11月至2018年11月期间40例OSA卒中患者。将患者分为CPAP治疗组（CPAP+康复治疗; n = 20）和对照组（单纯康复治疗; n = 20）。干预期为3周。主要结局是功能和认知改善，次要结局是睡眠相关改善。结果：CPAP治疗平均在入院后4.6 +/- 2.8天开始。在3周的干预后，两组患者的中风严重程度、功能和认知都有所改善。但干预后，CPAP治疗组注意力和计算力的变化程度明显高于对照组。此外，CPAP治疗组的睡眠质量和白天嗜睡的改善程度高于对照组。结论：CPAP治疗可以改善认知功能、睡眠质量和日间嗜睡，应将其作为脑卒中患者康复计划的一部分。我们的研究结果可能有助于韩国OSA患者的治疗。
Background: Obstructive sleep apnea (OSA) is common after stroke. Various studies on continuous positive airway pressure (CPAP) therapy for OSA after stroke have been published. However, there have been no studies from Korea and Asia. The present Korean study aimed to determine whether CPAP treatment during inpatient rehabilitation of stroke patients with sleep disorders, especially OSA, improves function, cognition, sleep quality, and daytime sleepiness. Methods: This single-blind randomized controlled study included 40 stroke patients with OSA between November 2017 and November 2018. The patients were divided into the CPAP treatment group (CPAP and rehabilitation; n = 20) and control group (only rehabilitation; n = 20). The intervention period was 3 weeks. The primary outcomes were function and cognition improvements, and the secondary outcomes were sleep-related improvements. Results: CPAP treatment started at an average of 4.6 +/- 2.8 days after admission. Both groups showed improvements in stroke severity, function, and cognition after the 3-week intervention. However, after the intervention, the degree of change in attention and calculation was significantly higher in the CPAP treatment group than in the control group. Additionally, the improvements in sleep quality and daytime sleepiness were greater in the CPAP treatment group than in the control group. Conclusion: CPAP treatment can improve cognitive function, sleep quality, and daytime sleepiness, and it should be considered as part of the rehabilitation program for patients with stroke. Our findings might help in the treatment of stroke patients with OSA in Korea.