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Real world challenges and barriers for positive airway therapy use in acute ischemic stroke patients.
Pascoe, Maeve; Grigg-Damberger, Madeleine M; Walia, Harneet; Andrews, Noah; Wang, Lu; Bena, James; Katzan, Irene; Uchino, Ken; Foldvary-Schaefer, Nancy.
Afiliación
  • Pascoe M; Department of Neurology, Sleep Disorders Center, Cleveland Clinic Neurological Institute, 9500 Euclid Avenue, S73, Cleveland, OH, 44195, USA.
  • Grigg-Damberger MM; Department of Neurology, University of New Mexico, Albuquerque, NM, USA.
  • Walia H; Baptist Hospital, Miami, FL, USA.
  • Andrews N; Department of Neurology, Sleep Disorders Center, Cleveland Clinic Neurological Institute, 9500 Euclid Avenue, S73, Cleveland, OH, 44195, USA.
  • Wang L; Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Bena J; Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Katzan I; Department of Neurology, Cerebrovascular Center, Cleveland Clinic, Cleveland, OH, USA.
  • Uchino K; Department of Neurology, Cerebrovascular Center, Cleveland Clinic, Cleveland, OH, USA.
  • Foldvary-Schaefer N; Department of Neurology, Sleep Disorders Center, Cleveland Clinic Neurological Institute, 9500 Euclid Avenue, S73, Cleveland, OH, 44195, USA. foldvan@ccf.org.
Sleep Breath ; 2024 Sep 16.
Article en En | MEDLINE | ID: mdl-39285020
ABSTRACT

PURPOSE:

Untreated obstructive sleep apnea (OSA) in patients with acute ischemic stroke (AIS) is associated with increased morbidity and mortality. However, diagnosing and treating OSA in AIS is challenging. We aimed to determine the feasibility of portable monitoring (PM) for diagnosis and positive airway pressure therapy for treatment of OSA in an inpatient stroke population.

METHODS:

We recruited inpatients with AIS from Cleveland Clinic. Those who consented underwent PM; participants with a respiratory event index (REI) ≥ 10 were offered auto-titrating positive airway pressure therapy (APAP). Ease-of-use questionnaires were completed. We summarized categorical variables using n(%) and continuous variables using mean ± SD or median [IQR].

RESULTS:

27 participants (age 59.8 ± 11.8, 51.9% female, 51.9% Black, BMI 33.4 ± 8.5) enrolled. The study ended early due to Medicare contracting that forced most patients to complete stroke rehabilitation outside the Cleveland Clinic health system. 59.3% had large vessel occlusions and 53.8% had moderate/severe disability (Modified Rankin score ≥ 2). PM was attempted in 21 participants, successful in 18. Nurses and patients rated the PM device as highly easy to use. 13 of 18 (72%) patients who had an REI ≥ 10 consented to APAP titration, but only eight (61.5%) of those 13 used APAP for more than one night, and only five (27.8%) used APAP up to 90 days with data captured for only one participant. Five required troubleshooting at titration, and only one had adherent APAP usage by objective assessment after discharge.

CONCLUSIONS:

This study demonstrates the real-world challenges of assessing and treating OSA in an AIS population, highlighting the necessity for further research into timely and feasible screening and treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Sleep Breath Asunto de la revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Sleep Breath Asunto de la revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania