Intensive Continuous Positive Airway Pressure Adherence Program During Stroke Rehabilitation

Area of Science:

• Neurology
• Sleep Medicine
• Rehabilitation Medicine

Background:

• Obstructive sleep apnea (OSA) is common in stroke patients, and continuous positive airway pressure (CPAP) may aid recovery.
• Poor adherence to CPAP treatment is a significant challenge in this population.

Purpose of the Study:

• To evaluate an intensive CPAP adherence program during and after inpatient stroke rehabilitation.
• To assess the program's impact on 3-month CPAP adherence and stroke recovery outcomes.

Main Methods:

• A single-arm study enrolled 90 stroke rehabilitation patients in an intensive CPAP adherence program.
• CPAP use was continued post-discharge for qualifying patients with OSA.
• Adherence was defined as ≥4 hours/day on ≥70% of days over 3 months.

Main Results:

• Of 62 patients qualifying for CPAP, 52 continued post-discharge.
• At 3 months, 62% of patients achieved adherence (average use 4.7 hours/day).
• Adherent patients showed greater improvements in cognitive function (FIM) and stroke severity (NIHSS).

Conclusions:

• An intensive CPAP adherence program initiated during stroke rehabilitation can achieve majority adherence.
• The program is effective even for patients with severe stroke and aphasia.
• CPAP adherence may promote improved stroke recovery outcomes.