Burden of Obstructive Sleep Apnea in Stroke (BOSAST)

描述（由申请人提供）：中风幸存者经常主诉疲劳、抑郁症状和认知功能下降。这些负担使中风的恢复和康复复杂化。虽然造成这些负担的因素可能很多，但有一个因素可能非常普遍，但很容易受到干预。来自世界各地的一致报告表明，50%的中风患者患有阻塞性睡眠呼吸暂停（OSA），这种疾病还与疲劳、抑郁症状和认知功能下降有关。阻塞性睡眠呼吸暂停也与炎症产物的增加有关，而炎症产物本身也与一系列相同的负担有关。本研究将调查225名中风康复中心的住院病人。患者将表现为疲劳、抑郁症状、认知功能问题以及炎症。他们的睡眠将被研究。OSA患者将随机分为10天治疗组，双盲组接受持续气道正压通气（CPAP）治疗或亚治疗性CPAP治疗。治疗10天后，对OSA患者和非OSA卒中患者的主观负担（疲劳、抑郁症状、认知功能）和炎症进行重新研究。这项研究将阐明阻塞性睡眠呼吸暂停对中风患者疲劳负担、抑郁症状和认知功能下降的影响。它将阐明炎症在这些负担症状中的可能作用，并将测试使用CPAP治疗OSA是否具有减轻负担和炎症的特定效果。关键词：阻塞性睡眠呼吸暂停，脑卒中，炎症，认知，抑郁症状公共卫生相关性：中风通常与疲劳负担、抑郁症状和认知问题有关。阻塞性睡眠呼吸暂停也有类似的症状，在中风患者中也很常见。这项研究将确定治疗中风患者的呼吸暂停是否会改善这些负担。

DESCRIPTION (provided by applicant): Stroke survivors frequently complain of fatigue, depressive symptoms, and decreased cognitive functioning. These burdens complicate the recovery and rehabilitation from stroke. While there may be many contributing factors to these burdens, one factor in particular may be both terribly common and yet readily susceptible to intervention. Consistent reports from around the world demonstrate that >50% of stroke patients have obstructive sleep apnea (OSA), a disorder that is also associated with fatigue, depressive symptoms, and decreased cognitive functioning. OSA is also associated with increases in inflammatory products which themselves are associated with the same array of burdens. This study will examine 225 inpatients at a stroke rehabilitation center. Patients will be characterized in terms of fatigue, depressive symptoms, and problems with cognitive functioning as well as inflammation. Their sleep will be studied. Patients with OSA will be randomized to 10 days treatment double blind with either continuous positive airways pressure (CPAP) treatment or to sub-therapeutic CPAP treatment. After 10 days of treatment, the OSA patients as well as the stroke patient without OSA will be restudied in terms of their subjective burdens (fatigue, depressive symptoms, and cognitive functioning) and inflammation. The study will shed light on the impact of OSA on stroke patients' burdens of fatigue, depressive symptoms, and decreased cognitive functioning. It will clarify the possible role of inflammation on these burden symptoms, and it will test if treatment of OSA with CPAP has a specific effect to decrease burdens as well as inflammation. Keywords: obstructive sleep apnea, stroke, inflammation, cognition, depressive symptoms. PUBLIC HEALTH RELEVANCE: Strokes are commonly associated with burdens of fatigue, depressive symptoms, and cognitive problems. Obstructive sleep apnea has similar symptoms and is also very common in stroke patients. This study will determine if treating apnea in stroke patients will improve these burdens.