Deans' stroke musings: Early Sleep Apnea Detection and Treatment in Stroke Rehabilitation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, November 5, 2011

Early Sleep Apnea Detection and Treatment in Stroke Rehabilitation

In my case they tested pulse oximetry on my finger one morning for 15 minutes and declared I didn't have sleep apnea. All they had to do was ask my wife and she would have told them I quit breathing some times at night. Finally got a CPAP and you can read about my unuse of it here:
http://oc1dean.blogspot.com/2010/09/stroke-fatigue.html
The new research here:
http://www.neurores.org/index.php/neurores/article/viewArticle/55/59

Abstract

Background: To assess whether the presence of obstructive sleep apnea is associated with changes in the motor, cognitive and functional outcomes in stroke patients. To investigate whether early intervention of obstructive sleep apnea impact the outcomes.

Methods: We performed overnight polysomnography in 25 patients admitted to the stroke rehabilitation unit. Those with an apnea/hypopnea index (AHI) > 10 per hour were randomized to standardized 30 day rehabilitation program with or without the addition of Bi level positive air pressure treatment at night. Cognitive, motor and functional status were assessed at baseline and at 30 days.

Results: The early Bi Level Positive Air Pressure treatment in the obstructive sleep apnea group (n = 13) produced improvements of the motor scores compared to patients who did not receive it (n = 12). The group with BiPAP treatment showed significant improvements in the The Fugl-Meyer Upper Extremity Motor Assessment score (p = 0.05) and the The Fugl-Meyer Lower Extremity Motor Assessment score (p = 0.019) compared with the group without BiPAP treatment.

Conclusions: Early obstructive sleep apnea detection and treatment suggest that BiPAP treatment plays a role in motor recovery of stroke patients. The observations suggest that polysomnography evaluation looking for obstructive sleep apnea should be part of the standardized evaluation of stroke patients at admission to stroke rehabilitation facilities.