Sleep for Stroke Management And Recovery Trial (Sleep SMART)

睡眠促进中风管理和恢复试验（Sleep SMART）

• 批准号: 9762989
• 负责人: DEVIN L BROWN
• 金额: $ 1031.85万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9762989
• 关键词: Acute; Address; Adherence; Affect; American Stroke Association; Biomedical Technology; Blinded; Blood Vessels; Cardiopulmonary; Caring; Coagulation Process; Cognitive; Continuous Positive Airway Pressure; Cost Savings; Country; Data; Devices; Diagnosis; Diagnostic; Event; Foundations; Goals; Home environment; Hospitalization; Hospitals; Hour; Hypoxemia; Infrastructure; Intervention; Investigational Therapies; Ischemic Stroke; Location; Mechanics; Methods; Monitor; Neurologic; Observational Study; Obstructive Sleep Apnea; Outcome; Patients; Phase; Physiological; Polysomnography; Population; Positioning Attribute; Prevention; Prevention Guidelines; Prevention trial; Protocols documentation; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Recurrence; Research Design; Research Personnel; Resources; Retrieval; Risk; Risk Factors; Role; Safety; Secondary Prevention; Sleep; Sleep Apnea Syndromes; Stroke; Stroke prevention; Sympathetic Nervous System; Testing; Therapeutic Intervention; Thrombectomy; Time; Titrations; Transient Ischemic Attack; Translating; Work; acute coronary syndrome; acute stroke; airway obstruction; base; care outcomes; community setting; comparative; cost; cost effective; design; digital; effective intervention; experience; functional outcomes; high risk; improved; innovation; insight; mortality; novel; novel therapeutics; open label; pilot trial; portability; post stroke; pragmatic trial; pressure; prevent; primary outcome; prospective; secondary outcome; stroke outcome; stroke patient; stroke recovery; stroke risk; thrombolysis; treatment as usual; trial design

Treatment of obstructive sleep apnea (OSA) for stroke prevention and recovery represents a rare chance to achieve transformative impact on post-stroke care and outcomes. OSA is highly prevalent after stroke (~75%) and is a known risk factor for poor functional outcome, mortality, and recurrent stroke. Furthermore, OSA is readily treated by a safe, simple, and relatively low-cost therapy, continuous positive airway pressure (CPAP). Observational studies have already demonstrated better stroke outcomes among patients who use CPAP, and multiple pilot trials have hinted at the benefits of CPAP after stroke. These studies have laid the foundation for a definitive trial on the role of CPAP in post-stroke management. The pressing need for this critical next step is highlighted in the latest American Stroke Association secondary stroke prevention guidelines. Therefore, the investigators now propose a phase III, open-label, blinded-endpoint assessment, multicenter, randomized, controlled trial to determine (1) whether treatment of OSA with CPAP after acute ischemic stroke or high-risk transient ischemic attack (TIA) helps to prevent recurrent stroke, acute coronary syndrome, and all-cause mortality 6 months after the event, and (2) whether treatment of OSA shortly after acute ischemic stroke improves stroke outcomes at 3 months. This study capitalizes on an efficient and cost-saving design involving a 6-month prevention trial with an embedded 3-month recovery trial. Many years of pilot work have identified the challenges related to the diagnosis and treatment of OSA after stroke. These valuable insights - combined with innovative digital and biomedical technology - have contributed to this highly pragmatic trial in which feasibility is paramount. In particular, as polysomnography and CPAP titration are seldom tolerated just after acute stroke, OSA will be identified through use of a portable cardiopulmonary sleep apnea test, and treated with an automatically adjusting CPAP device. Through state-of-the-art methods, subjects will receive centralized, real-time, nightly monitoring of CPAP use and proactive care management to maximize CPAP adherence. This approach simplifies and streamlines the diagnosis and treatment of OSA, which will facilitate implementation in hospitals with low resources. Consequently, this trial provides StrokeNet with an opportunity to use its network more fully, and will permit positive trial results to be readily translated into community settings across the U.S. This study represents a rare opportunity to change post-stroke care in a fundamental manner with a safe, cost-effective intervention that could improve both recovery and prevention in a substantial proportion of patients.

治疗阻塞性睡眠呼吸暂停（OSA）为中风的预防和恢复提供了难得的机会

项目成果

Associations between bedtime eating or drinking, sleep duration and wake after sleep onset: findings from the American time use survey.

• DOI: 10.1017/s0007114521003597
• 发表时间: 2021-09-13
• 期刊: BRITISH JOURNAL OF NUTRITION
• 影响因子: 3.6
• 作者: Iao, Su I.;Jansen, Erica;Shedden, Kerby;O'Brien, Louise M.;Chervin, Ronald D.;Knutson, Kristen L.;Dunietz, Galit Levi
• 通讯作者: Dunietz, Galit Levi

Protective effect of REM sleep during atrial bigeminy arrhythmia.

• DOI: 10.1016/j.sleep.2020.06.018
• 发表时间: 2020-10
• 期刊: Sleep medicine
• 影响因子: 4.8
• 作者: Gupta G;Farrehi PM;Chervin RD
• 通讯作者: Chervin RD

Disparities in sleep-wake patterns by labor force status: Population-based findings.

不同劳动力状况的睡眠-觉醒模式差异：基于人口的研究结果。

• DOI: 10.1080/07420528.2023.2253904
• 发表时间: 2023
• 期刊: Chronobiology international
• 影响因子: 2.8
• 作者: Lyu,Xiru;Dunietz,GalitLevi;O'Brien,LouiseM;Chervin,RonaldD;Koumpias,Antonios;Shedden,Kerby
• 通讯作者: Shedden,Kerby