TABLE 1

Randomized trials of positive airway pressure therapy in poststroke patients

AuthorsN (assigned to PAP)SettingDiagnostic testingCriteria for treatment/type of treatmentTiming of sleep study or start of treatmentDuration of treatmentMajor findings (differences in outcomes between groups)P valuea
Hsu et al6063 (31)Stroke rehabilitation unitPortable monitorAHI ≥ 30
ACPAP		Around 3 weeks after stroke8 weeksBarthel Index
NIH Stroke Scale
SF-36 physical / mental		.17
.62
.02 /.23
Parra et al6130 (15)Inpatient neurologyPortable monitorAHI ≥ 20
ACPAP to fixed CPAP		CPAP days 3–624 months1 month / 24 months Barthel Index > 1 point Rankin Scale > 1 point Canadian Neurologic Scale > 0.5.57 / NS
.002 / NS
.04 / NS
Ryan et al6244 (25)Inpatient stroke rehabilitation unitPSGAHI ≥ 15
CPAP titrated by PSG		Around 3 weeks after stroke1 monthEpworth Sleepiness Scale
Canadian Neurologic Scale
Functional Independence Measure		< .0001
< .001
.07
Bravata et al6355 (31)Inpatient stroke unitPSGNo AHI cutoff
ACPAP		ACPAP started within 48 hours of symptom onset1 monthImprovement in NIH Stroke Scale
Vascular events (transient ischemic attack, stroke, myocardial infarction, heart failure, death)		.03
.31
Parra et al64126 (57)Inpatient stroke unitPortable monitorAHI ≥ 20
ACPAP to fixed CPAP		CPAP days 3–65 yearsCardiovascular survival
Cardiovascular event-free survival		.015
.059
Khot et al6540 (20)Inpatient rehabilitation unitPortable monitor or PSGNo AHI cutoff
ACPAP or sham ACPAP		ACPAP around day 102 weeksFunctional Independence Measure-Total
Functional Independence Measure-Cognitive
Functional Independence Measure-Motor		.25
.04
.42
Aaronson et al6636 (20)Inpatient stroke rehabilitation unitPortable monitorAHI ≥ 15
CPAP		CPAP at 3–4 weeks after stroke4 weeksNIH Stroke Scale
Canadian Neurologic Scale
Activities of Daily Living / USER
Improvement in attention
Improvement in executive function		.08
.08
.11
.048
.001
Gupta et al6770 (34)Neurologic inpatient or outpatient clinicPSGAHI > 15
Fixed CPAP to ACPAP		CPAP around
6–8 weeks after stroke		12 monthsBlood pressure
New cardiovascular event
Barthel Index > 1 point
Modified Rankin Scale > 1 point
Epworth Sleepiness Scale		NS
.23
.96
.03
< .0001

  • ↵a When statistically significant (P < .05), the difference favors CPAP.

  • ACPAP = autoadjusting CPAP; AHI = apnea-hypopnea index; CPAP = continuous positive airway pressure; NIH = National Institutes of Health; NS = nonsignificant; PAP = positive airway pressure; PSG = polysomnography; SF-36 = Short Form 36; USER = Utrecht Scale for Evaluation of Rehabilitation