Effect of transnasal insufflation on sleep disordered breathing in acute stroke: a preliminary study

I'm sure that this research from 7 years ago was not enough to get your incompetent doctors to test out this low cost, low risk intervention. 

Effect of  on sleep disordered breathing in acute stroke: a preliminary study

Sleep and Breathing

September 2012, Volume 16, Issue 3, pp 759–764 | Cite as

• Authors
• Authors and affiliations

• José Haba-Rubio
• Daniela Andries
• Vincianne Rey
• Patrik Michel
• Mehdi Tafti
• Raphael Heinzer

• José Haba-Rubio
  • 1
• Daniela Andries
  • 1
• Vincianne Rey
  • 1
  • 2
• Patrik Michel
  • 2
• Mehdi Tafti
  • 1
  • 3
• Raphael Heinzer
  • 1
  Email author

1. 1.Center for Investigation and Research in SleepCentre Hospitalier Universitaire Vaudois and Université de LausanneLausanneSwitzerland
2. 2.Neurology ServiceCentre Hospitalier Universitaire Vaudois and Université de LausanneLausanneSwitzerland
3. 3.Center for Integrative GenomicsCentre Hospitalier Universitaire Vaudois and Université de LausanneLausanneSwitzerland

Original Article

First Online: 19 August 2011

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• 11 Citations

Abstract

Background and Purpose

Sleep disordered breathing (SDB) is frequent in acute stroke patients and is associated with early neurologic worsening and poor outcome. Although continuous positive airway pressure (CPAP) effectively treats SDB, compliance is low. The objective of the present study was to assess the tolerance and the efficacy of a continuous high-flow-rate air administered through an open nasal cannula (transnasal insufflation, TNI), a less-intrusive method, to treat SDB in acute stroke patients.

Methods

Ten patients (age, 56.8 ± 10.7 years), with SDB ranging from moderate to severe (apnea–hypopnea index, AHI, >15/h of sleep) and on a standard sleep study at a mean of 4.8 ± 3.7 days after ischemic stroke (range, 1–15 days), were selected. The night after, they underwent a second sleep study while receiving TNI (18 L/min).

Results

TNI was well tolerated by all patients. For the entire group, TNI decreased the AHI from 40.4 ± 25.7 to 30.8 ± 25.7/h (p = 0.001) and the oxygen desaturation index >3% from 40.7 ± 28.4 to 31 ± 22.5/h (p = 0.02). All participants except one showed a decrease in AHI. The percentage of slow-wave sleep significantly increased with TNI from 16.7 ± 8.2% to 22.3 ± 7.4% (p = 0.01). There was also a trend toward a reduction in markers of sleep disruption (number of awakenings, arousal index).

Conclusions

TNI improves SDB indices, and possibly sleep parameters, in stroke patients. Although these changes are modest, our findings suggest that TNI is a viable treatment alternative to CPAP in patients with SDB in the acute phase of ischemic stroke.