CLINICAL IMPLICATIONS OF OBSTRUCTIVE SLEEP APNEA (OSA) IN PATIENTS WITH RECENT STROKE: A SYSTEMATIC REVIEW

Abstract

Background: Obstructive sleep apnea (OSA) is a prevalent comorbidity in stroke patients, with mounting evidence linking its pathophysiological burden to stroke onset, severity, and recovery outcomes. This systematic review synthesizes findings from observational and interventional studies investigating the clinical implications of OSA among recent stroke patients. Methods: Following PRISMA 2020 guidelines, ten peer-reviewed studies published between 2010 and 2025 were analyzed. Data sources included PubMed, Scopus, Web of Science, and Embase. The review included adult stroke patients with diagnosed OSA, assessed using polysomnography or validated questionnaires. Outcomes examined encompassed survival, neurological recovery (NIHSS, mRS), hospitalization metrics, and response to CPAP therapy. Results: Across the reviewed studies, obstructive sleep apnea (OSA) was highly prevalent among stroke patients, affecting approximately 70–90% of cases. Its presence was linked to greater mortality, prolonged hospitalization, and delayed neurological recovery. Patients with OSA generally experienced poorer functional outcomes, while therapeutic interventions such as continuous positive airway pressure (CPAP) showed potential benefits for improving recovery and independence, though results varied by adherence and stroke severity. Neurophysiological findings indicated that post-stroke patients often exhibited altered respiratory patterns, with shorter apneic events and increased central apnea activity, suggesting that cerebrovascular damage influences OSA expression and severity. Conclusions: OSA significantly impacts stroke morbidity and mortality. Early detection and targeted CPAP intervention may optimize recovery outcomes. Future research should standardize OSA diagnostics and evaluate long-term benefits of sleep interventions in post-stroke rehabilitation.