A Review of Nursing Care for Sleep-Disordered Breathing After Stroke

BACKGROUND: Sleep-disordered breathing (SDB) occurs in 70% of stroke patients and is a risk factor for secondary stroke and poor outcomes. Discretionary nursing care provided to stroke patients with SDB is unexplored. This review examines nursing care for SDB after stroke. METHODS: We used Arksey and O'Malley's 5-stage framework. We systematically searched the PubMed and CINAHL databases through December 2023 for studies of interventions for SDB after stroke that could be implemented by nursing staff. Data on intervention characteristics, stroke and SDB types, timing, and outcomes were extracted. RESULTS: From 2866 screened articles, 10 studies met inclusion criteria. From these, we identified 5 distinct interventions: positional therapy, oropharyngeal muscle exercises, physical exercise, compression devices, and education. As confirmed by polysomnography or home sleep testing, 9 studies targeted obstructive sleep apnea. CONCLUSION: This review provides the first analysis of nurse-implementable interventions for poststroke SDB. The identified interventions appear promising for improving SDB parameters, particularly when adapted for stroke-specific care. Future research on developing standardized protocols that integrate these interventions into comprehensive care pathways will enhance the role of nurses in the early detection and management of poststroke SDB.