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Sleep and Breathing
Published in: Sleep and Breathing 3/2012

01-09-2012 | Original Article

Effect of transnasal insufflation on sleep disordered breathing in acute stroke: a preliminary study

Authors: José Haba-Rubio, Daniela Andries, Vincianne Rey, Patrik Michel, Mehdi Tafti, Raphael Heinzer

Published in: Sleep and Breathing | Issue 3/2012

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Abstract

Background and Purpose

Sleep disordered breathing (SDB) is frequent in acute stroke patients and is associated with early neurologic worsening and poor outcome. Although continuous positive airway pressure (CPAP) effectively treats SDB, compliance is low. The objective of the present study was to assess the tolerance and the efficacy of a continuous high-flow-rate air administered through an open nasal cannula (transnasal insufflation, TNI), a less-intrusive method, to treat SDB in acute stroke patients.

Methods

Ten patients (age, 56.8 ± 10.7 years), with SDB ranging from moderate to severe (apnea–hypopnea index, AHI, >15/h of sleep) and on a standard sleep study at a mean of 4.8 ± 3.7 days after ischemic stroke (range, 1–15 days), were selected. The night after, they underwent a second sleep study while receiving TNI (18 L/min).

Results

TNI was well tolerated by all patients. For the entire group, TNI decreased the AHI from 40.4 ± 25.7 to 30.8 ± 25.7/h (p = 0.001) and the oxygen desaturation index >3% from 40.7 ± 28.4 to 31 ± 22.5/h (p = 0.02). All participants except one showed a decrease in AHI. The percentage of slow-wave sleep significantly increased with TNI from 16.7 ± 8.2% to 22.3 ± 7.4% (p = 0.01). There was also a trend toward a reduction in markers of sleep disruption (number of awakenings, arousal index).

Conclusions

TNI improves SDB indices, and possibly sleep parameters, in stroke patients. Although these changes are modest, our findings suggest that TNI is a viable treatment alternative to CPAP in patients with SDB in the acute phase of ischemic stroke.
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Metadata
Title
Effect of transnasal insufflation on sleep disordered breathing in acute stroke: a preliminary study
Authors
José Haba-Rubio
Daniela Andries
Vincianne Rey
Patrik Michel
Mehdi Tafti
Raphael Heinzer
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Sleep and Breathing / Issue 3/2012
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-011-0572-3

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