Obstructive sleep apnea and stroke: The mechanisms, the randomized trials, and the road ahead

• When considered separately from cardiovascular disease, stroke is the third leading cause of death in the U.S. and is the leading cause of long-term disability in adults. New approaches that can be offered to the majority of ischemic stroke patients, can be continued throughout post-stroke care, can limit stroke severity, and can complement or even enhance rehabilitation, would transform ischemic stroke recovery. The treatment of obstructive sleep apnea (OSA) in patients with acute ischemic stroke may represent one such approach. This manuscript reviews the epidemiologic studies of the bidirectional association between OSA and stroke, and the mechanisms and molecular signatures of OSA leading to transient ischemic attack and stroke as well as the randomized controlled trials and observational cohort studies examining continuous positive airway treatment efficacy on the impact of stroke outcomes. Finally, the insights these studies provide on future research are also discussed. © 2021 Elsevier Ltd

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)

Keyword

Continuous positive airway pressure

Obstructive sleep apnea

Randomized controlled trials

Stroke

acute ischemic stroke

adaptive servo ventilation

apnea hypopnea index

atrial fibrillation

brain circulation

cardioembolic stroke

central sleep apnea syndrome

cerebrovascular accident

endothelial dysfunction

excessive daytime sleepiness

human

hypercapnia

hypercoagulability

hypertension

hypoxemia

ischemic stroke

oxidative stress

oxygen desaturation index

paradoxical embolism

patent foramen ovale

pathophysiology

prevalence

randomized controlled trial (topic)

Review

sleep disordered breathing

snoring

transient ischemic attack

Publication and Content Type

ref (subject category)

art (subject category)