Advances in screening for obstructive sleep apnea in stroke patients using the APNOEIC score.

INTRODUCTION: Obstructive sleep apnea (OSA) is highly prevalent in stroke patients and contributes to poor outcomes, including increased mortality and neurological deficits. This study aimed to develop a practical screening tool for detecting moderate-to-severe OSA in patients following acute ischemic stroke (AIS). MATERIALS AND METHODS: This prospective study enrolled AIS patients and assessed the respiratory event index (REI) within hours of stroke onset using polygraphy. Demographic and clinical data were collected and analyzed across OSA severities. Univariate and multivariate analyses identified predictors of moderate-to-severe OSA, and receiver operating characteristic (ROC) curves evaluated diagnostic accuracy. RESULTS: During the study period, 72 AIS patients were enrolled. Patients with moderate-to-severe OSA present with facial palsy, have an elevated Mallampati score, and experience a lower nocturnal minimum oxygen saturation. The APNOEIC scale, incorporating these parameters, showed superior diagnostic performance with a sensitivity of 97.8% and specificity of 55.5%, compared to traditional tools like STOP-BANG, which had a sensitivity of 93.3% and specificity of 18.5%. CONCLUSION: The APNOEIC score showed promising performance for identifying stroke patients at risk of moderate-to-severe OSA. Although results are preliminary and require external validation, implementing such a tool in stroke units could facilitate earlier diagnosis and treatment, potentially improving patient outcomes and reducing healthcare burden.