[Obstructive Sleep Apnea in Cerebrovascular Disease].

Obstructive sleep apnea (OSA) and cerebrovascular disease (CVD) have a bidirectional relationship. OSA serves as an independent risk factor for stroke, and a prior meta-analysis has demonstrated a 2.24-fold increased risk for stroke development. Conversely, the prevalence of OSA after stroke is remarkably high (50-70%, significantly impairing both functional and survival outcomes). Continuous positive airway pressure (CPAP) therapy is effective in improving neurological symptoms during the acute phase of stroke, although evidence for stroke prevention remains limited. However, OSA is often overlooked in patients with acute stroke because of specific challenges that include impaired consciousness, cognitive dysfunction, positioning limitations, and medical device constraints that complicate evaluation procedures. Current clinical practice faces several barriers to OSA assessment that include limited access to sleep-testing facilities and specialists, unclear timing for post-stroke evaluation, insufficient awareness among healthcare providers regarding sleep disorders, and inadequate evidence levels for treatment interventions. Future directions require a strengthened collaboration between neurologists and sleep medicine specialists to establish systematic OSA evaluation systems in the acute stroke phase. This comprehensive multidisciplinary approach, which involves not only physicians, but also nurses, therapists, pharmacists, and nutritionists, is essential for improving the quality of life and prognosis of patients with stroke with concurrent sleep-disordered breathing.