Screening For Sleep Disorders Research Articles

Assessment and management of sleep disorders in shift workers: Challenges and considerations for general practice.

Shift work is characterised by displaced sleep opportunities and associated sleep disturbance. Shift workers often report sleepiness and other wake time symptoms associated with poor sleep. However, clinical sleep disorders are also prevalent in shift workers. Although prevalence rates are similar or higher in shift workers compared with the general population, help seeking in shift workers with sleep disorders is low. This article aims to provide general practitioners with a contemporary overview of the prevalence rates for sleep disorders in shift workers, to clarify the existing evidence relating to mental and physical health consequences of sleep disorders in shift workers and to highlight the need to consider undiagnosed sleep disorders before attributing sleep-related symptoms solely to workschedules. Symptoms of sleep loss associated with shift work overlap with symptoms experienced by individuals living with sleep disorders. Although >40% of middle-aged Australians live with a sleep disorder that requires investigation and management, symptoms in shift workers are often attributed to the work schedule and, as a result, might not be investigated for appropriate diagnosis and treatment. We argue that screening for sleep disorders in shift workers with sleep complaints should be a priority.

Chronotype and depression in adolescence: Results from a UK birth cohort study

AbstractBackgroundResearch has established a bidirectional association between sleep disturbances and depression in both adults and youth, as well as links between depression and circadian rhythms and chronotype, predominantly in adult populations. However, the link between chronotype and depression in the general adolescent population, independently of poor sleep and prior mental health problems, remains unclear.MethodsThis study investigated the association between time‐to‐sleep (TTS) and depressive symptoms in middle adolescence (age 14 years) using data from a large, nationally representative birth cohort from the UK. The relationship between TTS and self‐reported number of depressive symptoms was adjusted for individual, family, and neighborhood characteristics, including sleep quality, earlier mental health, diet and family meal routines, body‐mass index, screen time, physical activity, chronic illness, special educational needs, peer victimization, socioeconomic status, maternal mental health, area safety and the built environment (air pollution).ResultsAn “evening” chronotype was positively associated with depressive symptoms, and biological sex moderated this association—with eveningness being more strongly related to depressive symptoms in females. TTS inconsistency between non‐school and school nights was associated with depressive symptoms and sleeping later on non‐school nights predicted fewer depressive symptoms. The results were robust to further sensitivity analyses that used the sleep midpoint on non‐school nights and controlled for sleep duration.LimitationsThis was a correlational study. The independent and dependent variables were self‐reported, and there was no clinical screening for sleep disorders. The TTS variables were provided in crude hour slots.ConclusionsA robust association was found between evening chronotype and depressive symptoms in middle adolescence, even after adjustment for a wide range of confounders. Eveningess and depressive symptoms were more strongly associated in females.

Educating Nurses in Sleep Screening, Brief Intervention, and Referral for Treatment.

Poor sleep is an unrecognized problem among cancer survivors that affects quality of life. However, screening for sleep disorders is not routine in cancer care. To fill this gap, a self-paced online training program was designed for RNs to screen patients for sleep disturbance and provide brief intervention or referral for treatment (Sleep-SBIRT). A three-phase evaluation pilot study included the following steps: (a) develop an online training program with in situ simulation; (b) implement the program with RNs at a comprehensive cancer center; and (c) evaluate module and quiz completion rates and focus group thematic analysis. Of the 22 RNs participating, 17 completed online modules and in situ simulation. The RNs were satisfied (M = 4.74/5, SD = 0.42) and self-confident (M = 4.45/5, SD = 0.45) with the learning. Focus group themes were learning new knowledge, learning online effectively, applying learning to in situ simulation, and intending to implement. The RNs gained knowledge applying Sleep-SBIRT, but future larger studies are warranted. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Associations of sleep disorders with all-cause and cause-specific mortality in cancer survivors: a cross-sectional analysis of the NHANES 2005–2016

BackgroundThe circadian clock and endoplasmic reticulum stress signaling play important roles in oncogenesis and development of cancer. Sleep disorders have been linked to an elevated risk of mortality in general populations. Nonetheless, the evidence for the sleep disorders-mortality association among cancer patients is limited. We aimed to prospectively investigate the association of sleep disorders with all-cause, cancer, and cardiovascular disease (CVD) mortality among cancer individuals.MethodsWe assessed 3187 participants with cancer from the National Health and Nutrition Examination Survey 2005–2016 cohorts with a median follow-up time of 83.0 months. Multivariable Cox proportional hazards models estimated the adjusted hazard ratio (HR) and 95% confidence interval (CI).ResultsMultivariable Cox proportional hazards models showed that sleep disorders were associated with a higher risk of all-cause mortality (HR 1.23, 95%CI: 1.06,1.42), cancer mortality (HR 1.30, 95%CI: 1.02, 1.66), and cardiovascular disease mortality (HR 1.35, 95%CI: 1.02, 1.80). After the total group was stratified by gender, the high HRs were observed in men (P < 0.05), not in women. The correlation between sleep disorders and higher long-term mortality was also significant after individuals who died within 2 years of follow-up were excluded, with HR 1.24 (95%CI: 1.07, 1.45) in model I, HR 1.20 (95%CI: 1.02, 1.42) in model II for long-term all-cause mortality, HR (95%CI: 1.00, 1.74) in model I for long-term cancer mortality, and HR 1.5 (95%CI:1.12, 2.02) in model I, HR 1.45 (95%CI: 1.06, 1.99) in model II for long-term CVD mortality.ConclusionsSleep disorders were associated with a higher risk of all-cause mortality, cancer mortality, and CVD mortality, as well as long-term mortality in cancer patients. Our finding underlies the importance of screening for sleep disorders for all cancer survivors and the urge to integrate sleep health as an important part of cancer care more effectively. Male individuals may be particularly vulnerable and could benefit from more frequent screening.

Screening for sleep apnea and other sleep disorders in patients with multiple sclerosis in Chillan, Chile, 2023

Screening for sleep apnea and other sleep disorders in patients with multiple sclerosis in Chillan, Chile, 2023

Prevalence and correlates of depressive symptoms among professional drivers in Saudi Arabia: A cross-sectional study.

Professional drivers in Saudi Arabia may be at increased risk for mental illness because of their expatriate status, long driving hours, and unhealthy lifestyles. To assess the prevalence and correlates of depressive symptoms among professional drivers in Saudi Arabia, most of whom are expatriates. Professional drivers (n = 324) were interviewed after convenient sampling of transportation companies. The Depression Anxiety Stress Scale-21 (DASS-21) was used to screen for depressive symptoms. Correlates of depressive symptoms were identified using Cox regression with a fixed follow-up time. Of the drivers, 20.4% had moderate to severe depressive symptoms. Sleep quality was found to be a significant independent correlate of depressive symptoms. Drivers with poor and fair sleep quality had higher risk of depressive symptoms than drivers with excellent sleep quality (poor: OR = 5.8, CI: 1.95-17.11; fair: OR = 4.5, CI: 1.68-11.96). The frequency of depressive symptoms among professional drivers in Saudi Arabia is high (one out of five). Companies should consider screening for depressive symptoms and sleep disorders among employees and should provide referrals as needed.

Sleep disorder risk, perceived control over sleep, and mental health symptoms in paramedicine students.

Paramedics commonly experience both poor sleep and mental health symptoms. Clarifying whether sleep or mental health symptoms are a challenge prior to commencement of employment is important, as early prevention and intervention initiatives during training could support these workers. Paramedicine students (n=53) were included, with sleep disorder screening (obstructive sleep apnea, insomnia and restless legs syndrome), and mental health outcomes (depressive symptoms: Patient Health Questionnaire-9, and anxiety symptoms: General Anxiety Disorder-7). Data were analysed using robust regression models, adjusted for age, sex, and shift work status. Meeting criteria for a sleep disorder (n=21) was associated with higher scores for anxiety (8.2 [95% CI: 5.9-10.5] v 4.6, [3.4-5.8]) and depressive symptoms (11.1 [8.6-13.6] v 4.4 [3.1-5.7)] compared to those who did not meet the criteria for a sleep disorder (n=32). Depressive symptoms were lower in those with perceived control over sleep (5.2 [3.2-7.2] v 9.8 [7.7-11.8]). There was no interaction between sleep disorder risk and perceived control over sleep on mental health symptoms. Investigation and management of factors contributing to low perceived control over sleep, together with early screening and management of sleep disorders, are likely to be important priorities to support paramedic student wellbeing prior to commencing shift work.

The connection of neuroendocrine diseases with sleep disorders

Most of the physiological functions of the body, including hormone secretion, differ during sleep and wakefulness. Circadian rhythm and homeostatic sleep pressure are the determining factors in falling asleep and maintaining sleep. Fluctuations in hormone levels are largely determined by circadian rhythms. The central biological clock located in the suprachiasmatic nucleus of the hypothalamus is synchronized with external signals, and largely determines the daily rhythms of hormone secretion. Many hormones can affect respiratory function during sleep, exacerbating sleep apnea when their secretion is excessive or deficient. Sleep disorders can occur in a number of neuroendocrine diseases, worsening the quality of life of patients and, in some cases, contributing to the development of life-threatening complications. Screening for sleep disorders, in particular the active detection of sleep apnea in acromegaly, hypothyroidism and hypercorticism, can significantly reduce the risk of complications with timely treatment.

Sleep disorders as both risk factors for, and a consequence of, stroke: A narrative review.

Sleep disorders are increasingly implicated as risk factors for stroke, as well as a determinant of stroke outcome. They can also occur secondary to the stroke itself. In this review, we describe the variety of different sleep disorders associated with stroke and analyze their effect on stroke risk and outcome. A search term-based literature review ("sleep," "insomnia," "narcolepsy," "restless legs syndrome," "periodic limb movements during sleep," "excessive daytime sleepiness" AND "stroke" OR "cerebrovascular" in PubMed; "stroke" and "sleep" in ClinicalTrials.gov) was performed. English articles from 1990 to March 2023 were considered. Increasing evidence suggests that sleep disorders are risk factors for stroke. In addition, sleep disturbance has been reported in half of all stroke sufferers; specifically, an increase is not only sleep-related breathing disorders but also periodic limb movements during sleep, narcolepsy, rapid eye movement (REM) sleep behavior disorder, insomnia, sleep duration, and circadian rhythm sleep-wake disorders. Poststroke sleep disturbance has been associated with worse outcome. Sleep disorders are risk factors for stroke and associated with worse stroke outcome. They are also a common consequence of stroke. Recent guidelines suggest screening for sleep disorders after stroke. It is possible that treatment of sleep disorders could both reduce stroke risk and improve stroke outcome, although further data from clinical trials are required.

A practical guide to improve sleep and performance in athletes

Sleep is vital for optimal mental and physical health. For athletes, optimizing sleep is becoming a popular strategy to enhance athletic performance. Athletes often complain of sleep problems including insufficient sleep and insomnia symptoms and are also at a higher risk for sleep disordered breathing. Sleep disorders and insufficient sleep can contribute to excessive sleepiness, daytime dysfunction, and performance problems. In contrast, better sleep provides benefits for physical health and athletic performance. For athletes, multiple factors can contribute to insufficient sleep. Sport-specific factors include frequent travel across time zones, competition and training schedules, high training loads, and sleeping in an unfamiliar environment. Non-sport-related factors include work, social, and family commitments; attitudes and sleeping beliefs; individual characteristics, such as chronotype or preference for morning or evening; and lifestyle choices. Fortunately, there are strategies that can be implemented to improve sleep in athletes including (a) education and emphasis on the importance of sleep; (b) sleep screening; providing extra sleep opportunities like (c) banking sleep and (d) napping; improving sleep hygiene like (e) proper light exposure; (f) a good pre-sleep routine; (g) a conducive sleep environment; (h) a strategy for supplementation; (i) utilizing circadian timing adjustments; and (j) jet lag management. Increased recognition of the importance of sleep from sport professionals and screening for sleep disorders and disturbances will be key for future athlete health, well-being, and performance.

P075 Strategies to improve sleep disorder diagnosis and management in the workplace: Perspectives of future shift workers living with sleep disorders

Abstract Shift workers with untreated sleep disorders face greater risk of negative health and safety outcomes. A population of particular concern is early-career shift workers, as 20% of young adults live with, largely undiagnosed, sleep disorders. This study aimed to explore what structures and qualities future shift workers would value in prospective workplaces regarding sleep disorder support and management. The study aims to inform the development of interventions that are acceptable to workers. Undergraduate paramedicine students were invited to complete an online survey and participate in a health services trial. The survey included validated sleep disorder screening questionnaires, with those identified at risk of a sleep disorder being offered further diagnostic testing or treatment. Participants completed a qualitative interview upon completion of the trial to discuss their experience and recommendations to improve screening and management of sleep disorders for shift workers. Seventeen paramedicine students (mean age 22.5±8.3 years, 59% female) with an undiagnosed sleep disorder were recruited into the trial. Early thematic analysis identified two key themes: Increasing education and awareness of sleep disorders and supporting access to health services. Almost half of the participants discussed the importance of increased awareness of sleep and sleep disorders during pre-employment training and in the workplace. Participants also identified convenience as an important factor in facilitating the management of sleep disorders. Facilitating access to sleep health services before workers are exposed to shift work and during early employment were suggested to improve sleep disorder identification and management for early-career shift workers.

The predictive effect of mid-pregnancy sleep disorders on perinatal depression within women with or without depression in early pregnancy: A prospective cohort study

BackgroundTo investigate the relationship between depression in early pregnancy and sleep quality in mid-pregnancy, and explore whether sleep disorders independently predicts depression across the perinatal period within women with or without depression in early pregnancy. MethodsData were collected at 7 time points from 12 weeks of pregnancy to 6 weeks postpartum. Multiple logistic regression and survival analysis were used to explore the relationship between sleep quality in mid-pregnancy and perinatal depression within women with or without depression in early pregnancy. Results390 women were included. Women with depression in early pregnancy were more likely to have sleep disorders and perinatal depression. Women with sleep disorders had a higher risk of perinatal depression compared to women without sleep disorders in mid-pregnancy. Stratified analysis based on whether depressed at 12 weeks of pregnancy found that among women without depression, those with sleep disorders in mid-pregnancy were more likely to have subsequent perinatal depression and appeared earlier; whereas, among women with depression, mid-pregnancy sleep disorders was not a predictor of subsequent perinatal depression. LimitationHigh rates of missed visits may lead to sample bias, with depression and sleep quality being assessed by self-report. ConclusionsWomen with depression in early pregnancy are more likely to have sleep disorders in mid-pregnancy. There is a strong correlation between sleep quality in mid-pregnancy and perinatal depression among women without depression in early pregnancy. Routine screening and intervention for sleep disorders should be a priority in perinatal care to reduce the incidence of perinatal depression.

Sleep disorders and suicide attempts following discharge from residential treatment

IntroductionSuicide is a significant public health concern and its prevention remains a top clinical priority of the Veterans Health Administration. Periods of transition in care (e.g., moving from inpatient to outpatient care) represent a period of increased risk. Sleep disorders are prevalent amongst Veterans and are modifiable risk factor for suicide. The present study examined the relationship of sleep disorders to time to suicide attempt amongst Veterans known to have attempted suicide in the 180 days following discharge from a Mental Health Residential Rehabilitation Treatment Program.MethodThe present sample was comprised of all Veterans enrolled in services with the Veterans Health Administration known to have attempted suicide following discharge from a Mental Health Residential Rehabilitation Treatment Program during Fiscal Years 13 and 14 (N = 1,489). To create this sample, electronic medical record data were extracted from two VHA data sources: the Corporate Data Warehouse and the Suicide Prevention Application Network.ResultsCox regression models revealed that Veterans with a sleep disturbance (N = 1,211) had a shorter time to suicide attempt than those without a sleep disturbance [Hazard Ratio (HR) = 1.16, CI (1.02–1.32)]. A subsequent Cox regression model including age, insomnia, nightmare disorder, and alcohol dependence revealed that sleep-related breathing disorders [HR = 1.19, CI (1.01–1.38)], alcohol dependence [HR = 1.16, CI (1.02–1.33)], and age group were associated with increased risk.ConclusionFindings indicate that sleep disturbance, primarily driven by sleep-related breathing disorders, was associated with time to suicide attempt in this sample of high-risk Veterans known to have attempted suicide in the 180 days following their discharge from a Mental Health Residential Rehabilitation Treatment Program. These findings reveal an opportunity to reduce risk through the screening and treatment of sleep disorders in high-risk populations.

Defining and Promoting Pediatric Pulmonary Health: Understanding Sleep and Ventilatory Health.

Healthy sleep and optimal ventilatory control begin in early development and are crucial for positive child outcomes. This paper summarizes information presented at the Sleep and Ventilatory Control sessions of the National Heart, Lung, and Blood-sponsored 2021 Defining and Promoting Pediatric Pulmonary Health workshop. These sessions focused on pediatric sleep health, screening for sleep health and sleep disorders in primary care using the electronic health record, infant sleep and ventilatory control, and home sleep testing. Throughout this summary, we discuss key gaps in and barriers to promoting sleep and ventilatory health that were identified during the workshop sessions. We conclude with strategies to address these gaps and barriers and directions for future multidisciplinary research, patient care, and training.

At-Home Polysomnography Versus In-Clinic Polysomnography for Sleep Disorders

&#x0D; Level 2 PSG may have moderate accuracy compared to Level 1 PSG for diagnosing obstructive sleep apnea. This conclusion was based on 1 study with limitations in reporting that reduce our certainty in the findings.&#x0D; There may be no significant differences in daytime sleepiness, hypertension, treatment adherence, and most quality-of-life measures for patients with OSA who were diagnosed with a Level 2 PSG compared with a Level 1 PSG (1 study).&#x0D; We did not find any studies on the diagnostic test accuracy or clinical utility of Level 2 PSG for the screening or diagnosing of other sleep disorders (e.g., central disorders of hypersomnolence, sleep-related movement disorders, parasomnias) that met our inclusion criteria.&#x0D; We did not find any studies on the cost-effectiveness of Level 2 PSG for screening or diagnosis of any sleep disorders in adults that met our inclusion criteria.&#x0D;

Impact of Dimethylfumarate on Sleep in Multiple Sclerosis Patients: An Actigraphic Study.

Sleep disorders in multiple sclerosis (MS) patients are common. Dimethylfumarate is an oral disease-modifying drug (DMT), whose impact on sleep is unknown. The aim of this study was to characterize actigraphic patterns in MS patients treated with dimethylfumarate. Twenty relapsing-remitting MS patients with low to a mild disability, aged 20-50y, treated with dimethylfumarate for more than 6 months, were enrolled. All subjects had no history of sleep disorders. Actigraphy was used to study sleep patterns during a seven-day period. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Twenty healthy subjects served as controls. Our results showed statistically significant differences between some actigraphic patterns in MS patients treated with dimethylfumarate and healthy subjects, but the values for patients were still within normal limits. PSQI score was higher in MS patients compared to controls. Our findings suggest that dimethylfumarate, an oral DMT with a favourable benefit-risk profile, does not strongly alter sleep patterns in MS patients with low to mild disability and with no history of sleep disorders. Actigraphy is a simple diagnostic tool, able to support an objective measure of sleep parameters. The simplicity of application may allow considering its use for a screening of sleep disorders in MS patients.

Barriers and enablers to screening, management and referral of sleep disorders in patients attending cardiac rehabilitation: A qualitative descriptive study.

To examine healthcare professional's knowledge about assessment and management of sleep disorders for cardiac patients and to describe the barriers to screening and management in cardiac rehabilitation settings. A qualitative descriptive study. Data were collected via semi-structured interviews. In March 2022, a total of seven focus groups and two interviews were conducted with healthcare professionals who currently work in cardiac rehabilitation settings. Participants included 17 healthcare professionals who had undertaken cardiac rehabilitation training within the past 5 years. The study adheres to the consolidated criteria for reporting qualitative research guidelines. An inductive thematic analysis approach was utilized. Six themes and 20 sub-themes were identified. Non-validated approaches to identify sleep disorders (such as asking questions) were often used in preference to validated instruments. However, participants reported positive attitudes regarding screening tools provided they did not adversely affect the therapeutic relationship with patients and benefit to patients could be demonstrated. Participants indicated minimal training in sleep issues, and limited knowledge of professional guidelines and recommended that more patient educational materials are needed. Introduction of screening for sleep disorders in cardiac rehabilitation settings requires consideration of resources, the therapeutic relationship with patients and the demonstrated clinical benefit of extra screening. Awareness and familiarity of professional guidelines may improve confidence for nurses in the management of sleep disorders for patients with cardiac illness. The findings from this study address healthcare professionals' concerns regarding introduction of screening for sleep disorders for patients with cardiovascular disease. The results indicate concern for therapeutic relationships and patient management and have implications for nursing in settings such as cardiac rehabilitation and post-cardiac event counselling. Adherence to COREQ guidelines was maintained. No Patient or Public Contribution as this study explored health professionals' experiences only.

Are sleep disorders associated with the risk of gastrointestinal cancer?-A case-control study.

Sleep disorders are among the most common health problems worldwide and are linked to a variety of physical and mental health problems. Recently, there has been increasing evidence of an association between sleep disorders and cancer risk. We aimed to investigate this association specifically for cancers of the gastrointestinal (GI) tract. Using the DA database (IQVIA), adult patients diagnosed with GI cancer between January 2010 and December 2022 were retrospectively compared to a 1:1 propensity score-matched cohort of patients without cancer. The outcome of the study was the association between sleep disorders and subsequent diagnosis of GI cancer. To determine whether sleep disorders were more common in patients with GI cancer than in patients without GI cancer, logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). After matching, 37,161 cases with GI cancer and 37,161 controls without cancer were available for analysis. No association with cancer was found for sleep disorders in the overall history before the index date (OR 1.04; 95% CI 0.96-1.12), but considering sleep disorders documented within 1year before the index date showed a positive association with GI cancer overall (OR 1.20; 95% CI 1.08-1.34). Stratified analyses by cancer site revealed higher odds of sleep disorders prior to diagnosis of gastric, pancreatic, and colorectal cancer. Our findings suggest that sleep disorders might be indicative of short-term health outcomes, including GI cancer, suggesting a role for sleep disorder screening in the context of cancer prevention efforts.

Insomnia and workplace productivity loss among young working adults: a prospective observational study of clinical sleep disorders in a community cohort.

To examine associations between three clinically significant sleep disorders (chronic insomnia, obstructive sleep apnoea, restless legs syndrome) and workplace productivity losses among young Australian adults. Prospective, observational study; 22-year follow-up of participants in the longitudinal birth cohort Raine Study (Perth, Western Australia). Currently employed 22-year-old Raine Study participants who underwent in-laboratory sleep disorder screening for moderate to severe obstructive sleep apnoea (apnoea-hypopnea index of more than fifteen events/hour or obstructive sleep apnoea syndrome) and were assessed for insomnia and restless legs syndrome using validated measures. Total workplace productivity loss over twelve months, assessed with the World Health Organization Health and Work Performance Questionnaire. Of 1235 contactable 22-year-old Raine Study cohort members, 554 people (44.9%; 294 women [53%]) underwent overnight polysomnography, completed the baseline sleep questionnaire, and completed at least three quarterly workplace productivity assessments. One or more clinically significant sleep disorders were identified in 120 participants (21.7%); 90 participants had insomnia (17%), thirty clinically significant obstructive sleep apnoea (5.4%), and two restless legs syndrome (0.4%). Seventeen people (14% of those with sleep disorders) had previously been diagnosed with a sleep disturbance by a health professional, including fourteen with insomnia. Median total workplace productivity loss was greater for participants with sleep disorders (164 hours/year; interquartile range [IQR], 0-411 hours/year) than for those without sleep disorders (30 hours/year; IQR, 0-202 hours/year); total workplace productivity loss was 40% greater for participants with sleep disorders (adjusted incidence rate ratio, 1.40; bias-corrected and accelerated 95% confidence interval, 1.10-1.76). The estimated population total productivity loss (weighted for disorder prevalence) was 28 644 hours per 1000 young workers per year, primarily attributable to insomnia (28 730 hours/1000 workers/year). Insomnia is a risk factor for workplace productivity loss in young workers. Tailored interventions are needed to identify and manage sleep disorders, particularly as most of the sleep disorders detected in the Raine Study had not previously been diagnosed.

Functional recovery after ischemic stroke: Impact of different sleep health parameters.

Sleep disturbances after ischaemic stroke include alterations of sleep architecture, obstructive sleep apnea, restless legs syndrome, daytime sleepiness and insomnia. Our aim was to explore their impacts on functional outcomes at month 3 after stroke, and to assess the benefit of continuous positive airway pressure in patients with severe obstructive sleep apnea. Ninety patients with supra-tentorial ischaemic stroke underwent clinical screening for sleep disorders and polysomnography at day 15 ± 4 after stroke in a multisite study. Patients with severe obstructive apnea (apnea-hypopnea index ≥ 30 per hr) were randomized into two groups: continuous positive airway pressure-treated and sham (1:1 ratio). Functional independence was assessed with the Barthel Index at month 3 after stroke in function of apnea-hypopnea index severity and treatment group. Secondary objectives were disability (modified Rankin score) and National Institute of Health Stroke Scale according to apnea-hypopnea index. Sixty-one patients (71.8 years, 42.6% men) completed the study: 51 (83.6%) had obstructive apnea (21.3% severe apnea), 10 (16.7%) daytime sleepiness, 13 (24.1%) insomnia, 3 (5.7%) depression, and 20 (34.5%) restless legs syndrome. Barthel Index, modified Rankin score and Stroke Scale were similar at baseline and 3 months post-stroke in the different obstructive sleep apnea groups. Changes at 3 months in those three scores were similar in continuous positive airway pressure versus sham-continuous positive airway pressure patients. In patients with worse clinical outcomes at month 3, mean nocturnal oxygen saturation was lower whereas there was no association with apnea-hypopnea index. Poorer outcomes at 3 months were also associated with insomnia, restless legs syndrome, depressive symptoms, and decreased total sleep time and rapid eye movement sleep.