Positive Airway Pressure Treatment for Sleep-Disordered Breathing is Rare During the First Year after Stroke: the BASIC Project

Objective/Background: Sleep-disordered breathing (SDB) is very common after ischemic stroke, and its treatment may have a positive impact on recovery from stroke and on secondary stroke prevention. This study sought to determine the prevalence of positive airway pressure (PAP) use after stroke.Patients/methods: Participants in the Brain Attack Surveillance in Corpus Christi (BASIC) project under-went a home sleep apnea test shortly after ischemic stroke. Demographics and co-morbidities were ascertained from the medical record. Self-reported PAP use (present vs absent) was assessed at 3, 6, and 12 months after stroke. Fisher exact tests and t-tests were used to compare PAP users versus non-users.Results: Of 328 participants who were found to have SDB after stroke, only 20 (6.1%) indicated using PAP at any point during the 12-month follow up period. High pre-stroke sleep apnea risk based on Berlin Questionnaire score, neck circumference, and co-morbid atrial fibrillation were associated with any self -reported PAP use; race/ethnicity, insurance status and other demographic variables were not associated with PAP use.Conclusions: Only a small proportion of individuals with ischemic stroke and SDB received treatment with PAP during the initial year after stroke among participants in this population-based cohort study in Nueces County, Texas. Closing the substantial treatment gap for SDB after stroke might improve sleep-iness and neurologic recovery. (c) 2023 Elsevier B.V. All rights reserved.