Stroke survivors frequently complain of fatigue, depressive symptoms, and decreased cognitive functioning. These burdens complicate the recovery and rehabilitation from stroke. While there may be many contributing factors to these burdens, one factor in particular may be both terribly common and yet readily susceptible to intervention. Consistent reports from around the world demonstrate that >50% of stroke patients have obstructive sleep apnea (OSA), a disorder that is also associated with fatigue, depressive symptoms, and decreased cognitive functioning. OSA is also associated with increases in inflammatory products which themselves are associated with the same array of burdens. This study will examine 225 inpatients at a stroke rehabilitation center. Patients will be characterized in terms of fatigue, depressive symptoms, and problems with cognitive functioning as well as inflammation. Their sleep will be studied. Patients with OSA will be randomized to 10 days treatment double blind with either continuous positive airways pressure (CPAP) treatment or to sub-therapeutic CPAP treatment. After 10 days of treatment, the OSA patients as well as the stroke patient without OSA will be restudied in terms of their subjective burdens (fatigue, depressive symptoms, and cognitive functioning) and inflammation. The study will shed light on the impact of OSA on stroke patients'burdens of fatigue, depressive symptoms, and decreased cognitive functioning. It will clarify the possible role of inflammation on these burden symptoms, and it will test if treatment of OSA with CPAP has a specific effect to decrease burdens as well as inflammation. Keywords: obstructive sleep apnea, stroke, inflammation, cognition, depressive symptoms.

Public Health Relevance

Strokes are commonly associated with burdens of fatigue, depressive symptoms, and cognitive problems. Obstructive sleep apnea has similar symptoms and is also very common in stroke patients. This study will determine if treating apnea in stroke patients will improve these burdens.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Lewin, Daniel S
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University of California San Diego
Schools of Medicine
La Jolla
United States
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