Don’t Neglect Sleep After Stroke

Have you had a recent stroke?  Has a relative or close friend of yours had a recent stroke?  You likely wish to help maximize recovery and minimize the likelihood of a second stroke.  Evolving evidence suggests that stroke patients may benefit from the treatment of obstructive sleep apnea, or the repeated collapse of the airway during sleep.

A recent study assessed stroke patients, immediately following stroke, for sleep apnea.  The great majority of stroke patients had obstructive sleep apnea.  Those patients who randomly received gold standard treatment for sleep apnea- continuous positive airway pressure (CPAP)- recovered far more effectively than those patients who received no sleep apnea treatment.  The magnitude of CPAP benefit is hard to pin down given the small sample size and variety of patients.  However, I’d think of it this way: many patients who would have otherwise needed a cane following their strokes might walk unassisted because of CPAP following stroke.

Another study followed patients during stroke rehabilitation.  Those stroke patients diagnosed with sleep apnea were assigned to CPAP or no treatment.  When assessed 1 month after CPAP start (by examiners who were blinded, or not told whether subjects were on CPAP), subjects demonstrated improvements in motor function, wakefulness, and mood.

As a physician trained in neurology and sleep disorders, I feel very strongly that many stroke patients would benefit from the treatment of sleep apnea.  Such treatment should start as soon as possible following stroke.  What can you do in the setting of a stroke?  Understand that doctors treating stroke have many priorities, and sleep apnea may not be the first.  Encourage us to consider evaluating you or your loved one for sleep apnea.