Researchers at Michigan Medicine in Ann Arbor are funneling an estimated $45 million into a randomized controlled trial they hope will clarify the link between stroke and obstructive sleep apnea.
The study, called Sleep SMART (Sleep for Stroke Management and Recovery Trial), will offer insight into an already established phenomenon, co-principal investigator Ronald Chervin, MD, MS, a neurologist and director of the University of Michigan Sleep Disorders Center, said in a release. Around 70 percent of stroke survivors have sleep apnea, but it’s unclear whether they developed apnea as a result of their stroke or whether the condition itself triggered a stroke.
“Our thought is that if we can prevent someone’s throat from closing during sleep—an event akin to choking that can happen repeatedly in the immediate aftermath of stroke—then we may actually be able to improve survival and perhaps recovery of some of the brain after the stroke,” Chervin said. “We really don’t know yet, which is why we need this randomized trial.”
With funding from the National Institutes of Health and help from researchers at 110 sites across the U.S., that trial plans to enroll 3,000 post-stroke patients in a large-scale, randomized environment. Patients are slated to start the trial while they’re still in the hospital, so researchers can begin their work immediately.
“It’s a seminal study,” Chervin said. “We have long had the suspicion that sleep apnea increases the risk for recurrent stroke and that it can impede recovery, but this will be the first large, randomized trial.”
The study will compare continuous positive airway pressure, or CPAP—the current standard treatment for sleep apnea—with standard stroke care in survivors, he said. At the three- and six-month mark, researchers will compare stroke-related outcomes between randomized groups.
Alongside the National Institute of Neurological Disorders and Stroke, a branch of the NIH, Fusion Health will help fund the study by supplying research sites with testing and CPAP equipment and helping to incorporate telemedicine into clinical practice. With Fusion’s equipment, the researchers hope to better monitor patient adherence and results without requiring overnight apnea tests or frequent clinic visits.
Ultimately, the authors said the aim of Sleep SMART is to determine whether future stroke survivors could be preventively screened and treated for obstructive sleep apnea.
“This is something we’re very hopeful will be an entirely new way of improving outcomes after stroke,” Devin Brown, MD, MS, a neurologist and co-principal investigator on the project, said in the release. “This would potentially give us a whole new facet of treatment that may be able to help both recovery and prevention, and it could be added on, potentially very safely, to any regimen, which makes that all the more exciting.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.