Stroke Program, Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.
Stroke Program, Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada.
J Stroke Cerebrovasc Dis. 2019 Nov;28(11):104317. doi: 10.1016/j.jstrokecerebrovasdis.2019.104317. Epub 2019 Aug 7.
Obstructive sleep apnea (OSA) occurs in about 70% of stroke and transient ischemic attack (TIA) patients and is associated with poor function and recurrent vascular events. Continuous Positive Airway Pressure (CPAP) has been shown to improve poststroke/TIA outcomes but adherence is generally poor. This study aimed to develop and conduct a preliminary assessment of educational materials for poststroke/TIA OSA.
This blinded pilot study involved the randomization of stroke/TIA patients to either an intervention group (who viewed an educational pamphlet and slideshow) or a control group (standard of care). Patient ratings were used to evaluate the educational materials. Changes in knowledge, daytime sleepiness, functional outcomes of sleep, and CPAP use were assessed at baseline and 6 months.
Total 93% of eligible patients consented to participate. Forty-eight participants were randomized to the control group (n = 23) or intervention group (n = 25). In the intervention group, all patients agreed or strongly agreed that the information in the educational materials was useful and that the wording was easy to understand. There were no significant changes in knowledge, daytime sleepiness, and functional outcomes of sleep between both groups at 6 months. In those who used CPAP, there was no significant difference in mean hours of CPAP use at the 6-month follow-up.
The educational program was feasible and easy to understand amongst stroke/TIA patients but did not lead to a significant change in outcomes or CPAP use. The lessons learned can be used to facilitate future development of educational materials and plan an adequately-powered trial.
阻塞性睡眠呼吸暂停（OSA）在约 70%的中风和短暂性脑缺血发作（TIA）患者中发生，与功能不良和复发性血管事件相关。持续气道正压通气（CPAP）已被证明可改善中风/TIA 后的结局，但依从性通常较差。本研究旨在开发和初步评估中风/TIA OSA 的教育材料。
这是一项盲法试点研究，将中风/TIA 患者随机分为干预组（观看教育小册子和幻灯片）或对照组（标准护理）。患者评分用于评估教育材料。在基线和 6 个月时评估知识、白天嗜睡、睡眠功能结局和 CPAP 使用的变化。
符合条件的患者中有 93%同意参与。48 名患者被随机分配到对照组（n=23）或干预组（n=25）。在干预组中，所有患者均同意或强烈同意教育材料中的信息有用，且措辞易懂。两组在 6 个月时的知识、白天嗜睡和睡眠功能结局均无显著变化。在使用 CPAP 的患者中，6 个月随访时 CPAP 使用的平均时间无显著差异。
该教育计划在中风/TIA 患者中可行且易于理解，但并未导致结局或 CPAP 使用的显著变化。所吸取的经验教训可用于促进未来教育材料的开发并计划进行充分的试验。
