STUDY OBJECTIVES This meta-analysis aimed to investigate the feasibility and effectiveness of continuous positive airway pressure (CPAP) treatment in stroke patients with sleep apnea. METHODS PubMed, EMBASE, and the Cochrane Library were searched from inception until July 28, 2022, for randomized controlled trials comparing the use of CPAP and usual treatment in patients with stroke or transient ischemic attack and sleep apnea. The primary outcome measures were the feasibility of CPAP therapy, neurological function, and functional status. RESULTS After screening 5,747 studies, 14 studies with 1,065 patients were included in this meta-analysis. Overall, 8 of the 14 studies recorded CPAP use, and the mean CPAP use was 4.47 hours per night (95% confidence interval [CI]: 3.85-5.09). The risk ratio of discontinuing CPAP was 1.50 (95% CI: 0.76-2.94; P = .24). Analysis of the neurofunctional scales showed that CPAP treatment improved neurological function (standardized mean difference: 0.28; 95% CI: 0.02-0.53), but there was substantial heterogeneity (I2 = 57%, P = .03) across the studies. CPAP treatment had no significant effect on functional status vs the control (standardized mean difference: 0.25; 95% CI: -0.01 to 0.51), but the studies also had substantial heterogeneity (I2 = 55%, P = .06). CONCLUSIONS CPAP treatment is feasible in patients with stroke and sleep apnea and may improve neurological outcomes in these patients. However, this finding should be interpreted with caution because of the substantial heterogeneity of current trials. CITATION Fu S, Peng X, Li Y, Yang L, Yu H. Effectiveness and feasibility of continuous positive airway pressure in patients with stroke and sleep apnea: a meta-analysis of randomized trials. J Clin Sleep Med. 2023;19(9):1685-1696.

中文翻译：

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持续气道正压通气治疗中风和睡眠呼吸暂停患者的有效性和可行性：随机试验的荟萃分析。

研究目的 这项荟萃分析旨在探讨持续气道正压通气 (CPAP) 治疗患有睡眠呼吸暂停的中风患者的可行性和有效性。方法 检索了从开始到 2022 年 7 月 28 日为止的 PubMed、EMBASE 和 Cochrane 图书馆，以比较 CPAP 与常规治疗在中风或短暂性脑缺血发作和睡眠呼吸暂停患者中的使用情况的随机对照试验。主要结局指标是 CPAP 治疗的可行性、神经功能和功能状态。结果 经过筛选 5,747 项研究后，本次荟萃分析纳入了 14 项研究，涉及 1,065 名患者。总体而言，14 项研究中有 8 项记录了 CPAP 使用情况，平均 CPAP 使用时间为每晚 4.47 小时（95% 置信区间 [CI]：3.85-5.09）。停止 CPAP 的风险比为 1.50 (95% CI: 0.76-2.94; P = .24)。神经功能量表分析表明，CPAP 治疗改善了神经功能（标准化平均差：0.28；95% CI：0.02-0.53），但各研究之间存在显着的异质性（I2 = 57%，P = .03）。与对照组相比，CPAP 治疗对功能状态没有显着影响（标准化平均差：0.25；95% CI：-0.01 至 0.51），但研究也存在显着的异质性（I2 = 55%，P = .06）。结论 CPAP 治疗对于中风和睡眠呼吸暂停患者是可行的，并且可以改善这些患者的神经系统结果。然而，由于当前试验存在很大的异质性，因此应谨慎解释这一发现。引文 Fu S, Peng X, Li Y, Yang L, Yu H. 脑卒中和睡眠呼吸暂停患者持续气道正压通气的有效性和可行性：随机试验的荟萃分析。J 临床睡眠医学杂志。2023；19(9):1685-1696。