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Effect of CPAP Therapy in Poststroke Patients with Sleep-Disordered Breathing: A Systematic Review and Meta-Analysis
Jeppe Suusgaard1,2, Nikolaj Folke la Cour Karottki3, Anders Sode West4
1Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Copenhagen University Hospital, Rigshospitalet, Denmark.
European Neurology
|March 6, 2026
Summary
Continuous positive airway pressure (CPAP) therapy may reduce recurrent stroke and mortality in patients with sleep-disordered breathing (SDB) after stroke or transient ischemic attack (TIA). Outcomes depend on adherence to CPAP treatment.
Area of Science:
- Neurology
- Cardiology
- Sleep Medicine
Background:
- Sleep-disordered breathing (SDB), especially obstructive sleep apnea (OSA), is prevalent post-stroke and linked to adverse outcomes.
- Continuous positive airway pressure (CPAP) is a potential intervention, but its effectiveness in stroke survivors is unclear.
Purpose of the Study:
- To systematically evaluate the efficacy of CPAP therapy in adults following stroke or transient ischemic attack (TIA) with SDB.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies.
- Searched MEDLINE, Embase, and Cochrane CENTRAL for studies comparing CPAP with control groups.
- Analyzed primary outcomes of recurrent stroke/TIA and all-cause mortality, and secondary outcomes including functional and cognitive status.
Main Results:
- CPAP therapy significantly reduced the odds of recurrent stroke (OR 0.49).
- Observational data suggested CPAP lowered all-cause mortality (OR 0.50), though RCTs showed no short-term effect.
- High CPAP adherence correlated with better functional and cognitive outcomes and reduced sleepiness.
Conclusions:
- CPAP therapy shows promise in reducing stroke recurrence and potentially all-cause mortality in post-stroke SDB patients.
- Functional and cognitive benefits are inconsistent and strongly associated with patient adherence to CPAP treatment.
Keywords:
Continuous positive airway pressureFatigueMortalityObstructive sleep apneaRehabilitationStrokeMore Related Videos
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