Interesting paper on stroke and CPAP etc.

[JDS74]

https://onlinelibrary.wiley.com/doi/ful ... /ene.14201

[Miss Emerita]

Many thanks for posting the link. If others are interested, here's the high-level summary:


Results

Severe obstructive sleep apnoea (OSA) doubles the risk for incident stroke, especially in young to middle‐aged patients. Continuous positive airway pressure (CPAP) may reduce stroke risk, especially in treatment‐compliant patients. The prevalence of OSA is high in stroke patients and can be assessed by polygraphy. Severe OSA is a risk factor for recurrence of stroke and may be associated with stroke mortality, whilst CPAP may improve stroke outcome. It is not clear if insomnia increases stroke risk, whilst the pharmacotherapy of insomnia may increase it. Periodic limb movements in sleep (PLMS), but not restless limb syndrome (RLS), may be associated with an increased risk of stroke. Preliminary data suggest a high frequency of post‐stroke insomnia and RLS and their association with a less favourable stroke outcome, whilst treatment data are scarce.
Discussion/Conclusion

Overall, the evidence base is best for OSA relationship with stroke and supports active diagnosis and therapy. Research gaps remain especially regarding insomnia and RLS/PLMS relationships with stroke.

[Pugsy]

This made me remember something Stuart (Bleep designer) told me when we talked about what our turning point in accepting cpap therapy and how we got to this point in our lives.

Stuart is a RT and for years did sleep tests as his profession in life. He knew full well what OSA was/is and he knew that he exhibited signs and symptoms himself of having this condition. His aha moment came after he did a sleep study on a guy with severe OSA who he put a mask on during a split night study. It was obvious that cpap help the guy's breathing, blood pressure, oxygen levels......etc.
The guy went home with a prescription for cpap.
Then a few weeks later the guy and his wife came back to his facility but this time in a wheel chair and obviously stroke impaired.
The guy didn't follow up and use the prescribed cpap because he "couldn't handle it"....then he had a stroke and was now back for another sleep study to try to figure out suitable pressures to deal with the OSA.

Stuart said right then he decided to do what he needed to do to get his OSA therapy started and that was over 22 years ago.
He saw first hand and rather quickly what OSA can do to a person and what happens with the stroke. He wanted to prevent that stroke from happening to him and his family. Stuart is not old....not even now much less 22 years ago when all this started. He's a lot younger than I am. He's not fat or anything like that either. This is not something that only fat old men have a problem with. We need to get past that old stereotype.

I have always maintained that even if I hadn't seen any reduction in any typical OSA symptom that I would still use cpap as a preventative measure....preventing that heart attack or stroke if at all possible..
This is why it breaks my heart when I see people complain that cpap "didn't help me feel better" and they blow off continuing with the therapy because they think it doesn't help. Maybe it doesn't always show up as obvious help...but it can actually prevent something really bad from happening. That heart attack or stroke that comes up short and a person ends up seriously impaired.

[chunkyfrog]

I "heartily" commend anyone who perseveres with cpap therapy
in the absense of positive immediate, significant results.
It is much easier if cpap addresses nightmares, morning headache, and EDS.
Not so easy to heal your insides when "OK" has become enough
and wearing a mask all night is "too difficult" to do.

[Arlene1963]

A few weeks ago during the height of Covid-19 angst I got into the bad habit of sleeping without my mask. I'm not sure why this happened but anyway, it did …

I take my blood pressure daily, and started to notice that my blood pressure was creeping up. My blood pressure is normally very well controlled with medication and diligent CPAP use. I also noticed my resting pulse went from the mid to low 60s into the mid 70s.

So I started making myself use CPAP all night again.

My morning BP numbers almost immediately dropped back to their normal range. Ditto my resting heart rate.

[chunkyfrog]

Good for you, Arlene.
Regular blood pressure checks are a great plan.
I need to get a home tester, as the public meters are left arm only, and I can't do that.

[kteague]

Many thanks for posting the link. If others are interested, here's the high-level summary:
Results... Periodic limb movements in sleep (PLMS), but not restless limb syndrome (RLS), may be associated with an increased risk of stroke. ..
Research gaps remain especially regarding insomnia and RLS/PLMS relationships with stroke.