Abstract
As Brown et al point out in this issue of Stroke , sleep disordered breathing is associated both with increased stroke risk and increased poststroke morbidity and mortality.1 Obstructive sleep apnea (OSA) is common after stroke, occurring in as many as 60 to 90% of patients, although the natural history of OSA in stroke patients, especially when OSA is first identified during the acute hospitalization, is not well studied. Because effective treatment, namely continuous positive airway pressure (CPAP), is effective at reducing sleep apnea and has been shown in small studies to be feasible in stroke patients, it is reasonable to consider planning trials to evaluate whether CPAP can improve stroke outcomes and reduce subsequent vascular events. The authors used decision–analytic modeling to identify the magnitude of benefit that identification and treatment of OSA would need to demonstrate to be considered cost-effective. They estimated the magnitude of benefit …
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