Abstract

Obstructive sleep apnea is highly prevalent in the post-stroke population, and has been shown to affect cognitive, neurological, and functional status. Continuous positive airway pressure (CPAP) treatment is one of the most effective interventions for obstructive sleep apnea, but compliance is often low due to confounding effects of co-occurring conditions, side effects of treatment titration procedures, and individual patient personality characteristics, perceptions, and social factors. Current research suggests that CPAP treatment for obstructive sleep apnea is not associated with significant risk and can subsequently improve post-stroke motor and neurocognitive function. However, effects of CPAP treatment on post-stroke speech and language recovery remain unclear. Post-stroke communication disorders (e.g., aphasia, dysarthria, and apraxia) are also highly prevalent in this population. Knowledge of the potential positive impact of CPAP on language recovery could contribute to patients’ motivation to comply with CPAP treatment and provide incentive for speech-language pathologists to refer patients to sleep medicine specialists. In this review of the literature, we examine the question of what effect CPAP treatment may have on post-stroke speech and language function and recovery, as well as summarize the current knowledge on cognitive, neurological, and functional effects. While this review of the literature found CPAP to have varying effects on different cognitive domains, there was not sufficient evidence to determine effects on language recovery. Further research is necessary to determine the potential effects of CPAP treatment on speech and language recovery among stroke patients.

Highlights

  • Sleep disordered breathing (SDB) is a set of disorders primarily characterized by respiratory abnormalities during sleep

  • Study Characteristics The included studies, by Kim et al, Aaronson et al, and Ryan et al, investigated the use of Continuous positive airway pressure (CPAP) treatment during rehabilitation of stroke patients to determine its potential benefit for improving function, cognition, language, quality of sleep, sleepiness, and affect [2,3,6]

  • The investigators for these studies recruited acute stroke patients with SDB and compared a group receiving CPAP to a group receiving the standard course of treatment [2,3,6]

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Summary

Introduction

Sleep disordered breathing (SDB) is a set of disorders primarily characterized by respiratory abnormalities during sleep. Defined as an SDB, obstructive sleep apnea (OSA) consists of obstructions in the upper airways and cessations in breathing during sleep. SDB ranging from moderate to severe is present in about 26% of people [1]. The prevalence of moderate to severe SDB in the acute post-stroke population ranges from 50–70% [1]. SDB has been found to impact cognitive and functional recovery in stroke patients [2]. When stroke patients experience SDB, it can cause neurological deterioration, lead to longer hospital stays, impact post-stroke mortality rates, negatively impact functional level, and influence both short- and long-term stroke outcomes [2,3]

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