Continuous Positive Airway Pressure Treatment Reduces Mortality in Patients with Ischemic Stroke and Obstructive Sleep Apnea: A 5-Year Follow-up Study
Abstract
Rationale: Obstructive sleep apnea (OSA) is an independent risk factor for stroke, but little is known about the role of continuous positive airway pressure (CPAP) on mortality in patients with stroke. Objectives: To analyze the independent impact of long-term CPAP treatment on mortality in patients with ischemic stroke. Methods: Prospective observational study in 166 patients with ischemic stroke. Sleep study was performed in all of them and CPAP treatment was offered in the case of moderate to severe cases. Patients were followed-up for 5 years to analyze the risk of mortality. Measurements and Main Results: Of 223 patients consecutively admitted for stroke, a sleep study was performed on 166 of them (2 mo after the acute event). Thirty-one had an apnea–hypopnea index (AHI) of less than 10; 39 had an AHI between 10 and 19, and 96 had an AHI of 20 or greater. CPAP treatment was offered when AHI was 20 or greater. Patients were followed up in our outpatient clinic at 1, 3, and 6 months, and for every 6 months thereafter for 5 years (prospective observational study). Mortality data were recorded from our computer database and official death certificates. The mean age of subjects was 73.3 ± 11 years (59% males), and the mean AHI was 26 (for all patients with a predominance of obstructive events). Patients with an AHI of 20 or greater who did not tolerate CPAP (n = 68) showed an increase adjusted risk of mortality (hazards ratio [HR], 2.69; 95% confidence interval [CI], 1.32–5.61) compared with patients with an AHI of less than 20 (n = 70), and an increased adjusted risk of mortality (HR, 1.58; 95% CI, 1.01–2.49; P = 0.04) compared with patients with moderate to severe OSA who tolerated CPAP (n = 28). There were no differences in mortality among patients without OSA, patients with mild disease, and patients who tolerated CPAP. Conclusions: Our results suggest that long-term CPAP treatment in moderate to severe OSA and ischemic stroke is associated with a reduction in excess risk of mortality.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In studies by Martinez-Garcia and colleagues, treatment of sleep apnoea was associated with significantly reduced cardiovascular mortality.
“For example, in studies by Martinez-Garcia and colleagues, treatment of sleep apnoea was associates with significantly reduced cardiovascular mortality (Campos-Rodriguez et al., 2012; Martinez-Garcia et al., 2009).”
From Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease? (2014) · cites this paper as Martinez-Garcia et al., 2009
The citation lists haven’t been fetched yet
References 42 · Cited by 390
- Authors
- Martínez-García, M. A., Soler-Cataluña, J. J., Ejarque-Martínez, L., Soriano, Y., Román-Sánchez, P., Illa, F. B., Canal, J. M. M., & Durán-Cantolla, J.
- Affiliations
- Pneumology Unit and
- Pneumology Service, Arnau de Vilanova Hospital and Centro de Investigacio´n Biome´dica en Red de Enfermedades Respiratorias (CIBERes), Lleida
- Internal Medicine Service, Requena General Hospital, Valencia
- Hospital Universitari Arnau de Vilanova (ES)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES)
- Sleep Disorders Unit, Txagorritxu Hospital and Centro de Investigacio´n Biome´dica en Red de Enfermedades Respiratorias (CIBERes), Vitoria, Spain
- ORCID
- Román-Sánchez, Pilar
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-07-01
- Volume
- 180
- Issue
- 1
- Pages
- 36-41
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2128233298
- Cited by
- 390
- References
- 42
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 7 · 2023: 12 · 2022: 14 · 2021: 14 · 2020: 15 · 2019: 22 · 2018: 28 · 2017: 21 · 2016: 25 · 2015: 26 · 2014: 39 · 2013: 40 · 2012: 33
- FWCI
- 23.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Sociedad Valenciana de Neumología
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- continuous positive airway pressure, obstructive sleep apnea, ischemic stroke, mortality, apnea-hypopnea index, stroke risk factors, long-term follow-up, sleep-disordered breathing, comorbidity management, stroke rehabilitation, stroke self-management
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Patient Compliance, Prospective Studies, Sleep Apnea Syndromes, Spain, Survival Analysis, Stroke, Continuous Positive Airway Pressure
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
