Stroke and CPAP Outcome Study: A Sham-controlled Trial of CPAP Among Stroke Rehabilitation Patients
Stroke and CPAP Outcome Study: A Sham-controlled Trial of CPAP Among Stroke Rehabilitation Patients
The purpose of this study is to assess the effect of continuous positive airway pressure
 (CPAP) on functional outcome in patients with acute stroke, the investigators conducted a
 sham-controlled, double-blind pilot trial during inpatient rehabilitation.

 Patients with acute stroke were recruited and randomly assigned to auto-titrating or
 sham-CPAP during their rehabilitation stay.
All acute stroke patients admitted to the inpatient rehabilitation service at the University
 of Washington were invited to participate in the study. Given the high prevalence of
 obstructive sleep apnea (OSA) in this population, no screen for OSA was performed. Enrolled
 patients were assigned randomly to active-CPAP with auto-titrating pressures or to sham-CPAP
 with an otherwise identical device but with pressures ≤ 1 cm water. Subjects used active or
 sham-CPAP for the duration of inpatient rehabilitation, but no longer than 28 days. CPAP
 compliance was assessed by memory card that recorded mask-on time. Other information on
 download, such as apnea-hypopnea index, was only available on active-CPAP and not assessed by
 investigators in real time. In this study, the investigators defined tolerance as any
 continued use of CPAP at night and adherence as mean hours of CPAP use per night in those who
 were CPAP tolerant.
Inclusion Criteria:

 -  greater than 18 years of age

 -  admitted to an inpatient rehabilitation unit at the University of Washington

 -  head CT or brain MRI demonstrating an ischemic or hemorrhagic stroke

 -  enrolled in another research study

 Exclusion Criteria:

 -  stroke was a subarachnoid hemorrhage or due to a secondary cause (vascular
 malformation, vasculitis, brain tumor, head trauma, or predisposition to bleeding)

 -  history of CPAP use, advanced chronic lung disease requiring supplemental oxygen,
 heart failure (NYHA class III or IV)

 -  require a nasogastric feeding tube.