title: Effects of Continuous Positive Airway Pressure on Cognitive and Functional Outcome of Stroke Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) in stroke patients is associated with worse functional and cognitive status during inpatient rehabilitation. We hypothesized that a four-week period of continuous positive airway pressure (CPAP) treatment would improve cognitive and functional outcomes.
  
  
  METHODS
  We performed a randomized controlled trial in stroke patients admitted to a neurorehabilitation unit. Patients were assigned to rehabilitation treatment as usual (control group) or to CPAP treatment (CPAP group). Primary outcomes were cognitive status measured by neuropsychological examination, and functional status measured by two neurological scales and a measure of activities of daily living (ADL). Secondary measures included sleepiness, sleep quality, fatigue, and mood. Tests were performed at baseline and after the four-week intervention period.
  
  
  RESULTS
  We randomly assigned 20 patients to the CPAP group and 16 patients to the control group. The average CPAP compliance was 2.5 hours per night. Patients in the CPAP group showed significantly greater improvement in the cognitive domains of attention and executive functioning than the control group. CPAP compliance was associated with greater improvement in cognitive functioning. CPAP did not result in measurable improvement on measures of neurological status or ADL, or on any of the secondary measures.
  
  
  CONCLUSIONS
  CPAP treatment improves cognitive functioning of stroke patients with OSA.
  
  
  CONCLUSIONS
  A commentary on this article appears in this issue on page 467.
authors.affiliation: Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed).|Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands.
authors.forename: Justine A
authors.initials: JA
authors.lastname: Aaronson
authors.affiliation: Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands.
authors.forename: Winni F
authors.initials: WF
authors.lastname: Hofman
authors.affiliation: Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed).
authors.forename: Coen A M
authors.initials: CA
authors.lastname: van Bennekom
authors.affiliation: Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed).
authors.forename: Tijs
authors.initials: T
authors.lastname: van Bezeij
authors.affiliation: Department of Pulmonary Medicine, Medical Center Alkmaar, Alkmaar, Netherlands.
authors.forename: Joost G
authors.initials: JG
authors.lastname: van den Aardweg
authors.affiliation: Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed).
authors.forename: Erny
authors.initials: E
authors.lastname: Groet
authors.affiliation: Heliomare Research & Development and Heliomare Rehabilitation, Wijk aan Zee, Netherlands (institution at which the work was performed).
authors.forename: Wytske A
authors.initials: WA
authors.lastname: Kylstra
authors.affiliation: Department of Psychology, Brain and Cognition group, University of Amsterdam, Amsterdam, Netherlands.|Department of Neurology, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Ben
authors.initials: B
authors.lastname: Schmand
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications*; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy*; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: CPAP; cognitive status; functional status; obstructive sleep apnea; stroke