Continuous positive airway pressure treatment in sleep apnea prevents new vascular events after ischemic stroke

Chest. 2005 Oct;128(4):2123-9. doi: 10.1378/chest.128.4.2123.


Study objectives: A study was made of the role of continuous positive airway pressure (CPAP) treatment in the prevention of new vascular events following ischemic stroke or transient ischemic attack.

Design: Prospective study.

Patients and interventions: Demographic data, vascular risk factors, clinical manifestations associated to sleep apnea-hypopnea syndrome, and neurologic parameters were recorded in a group of patients presenting with acute ischemic stroke at least 2 months previously. A polygraphic study was carried out 2 months after the acute episode in all patients, with the prescription of CPAP in the event of an apnea-hypopnea index (AHI) > or = 20. Two groups were defined: patients who could tolerate CPAP (group 1), and patients who could not tolerate CPAP after 1 month of initial adaptation (group 2). Patients with an AHI < 20 were excluded. The incidence of new vascular events was evaluated throughout follow-up (18 months) in all patients, with an analysis of the role of CPAP in protecting the patients against such events.

Results: Ninety-five patients were studied. Fifty-one patients (53.7%; mean age, 72.7 +/- 9.4 years [+/- SD]) presented with an AHI > or = 20, and 15 patients (29.4%) tolerated CPAP. The incidence of new vascular events was greater in group 2 (6.7%) vs group 1 (36.1%; long-rank, p = 0.03). Intolerance of CPAP increased the probability of a new vascular event fivefold (odds ratio, 5.09) adjusted for other vascular risk factors and neurologic indexes.

Conclusions: We concluded that CPAP treatment during 18 months in patients with an AHI > or = 20 afforded significant protection against new vascular events after ischemic stroke.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Brain Ischemia / complications
  • Brain Ischemia / physiopathology*
  • Continuous Positive Airway Pressure*
  • Female
  • Humans
  • Incidence
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / physiopathology
  • Male
  • Patient Selection
  • Risk Factors
  • Sleep Apnea Syndromes / etiology
  • Sleep Apnea Syndromes / therapy*
  • Vascular Diseases / prevention & control*