Obstructive Sleep Apnea: An Unusual Cause of Hemorrhagic Stroke

A wearable device for at-home obstructive sleep apnea assessment: State-of-the-art and research challenges

In the last 3 years, almost all medical resources have been reserved for the screening and treatment of patients with coronavirus disease (COVID-19). Due to a shortage of medical staff and equipment, diagnosing sleep disorders, such as obstructive sleep apnea (OSA), has become more difficult than ever. In addition to being diagnosed using polysomnography at a hospital, people seem to pay more attention to alternative at-home OSA detection solutions. This study aims to review state-of-the-art assessment techniques for out-of-center detection of the main characteristics of OSA, such as sleep, cardiovascular function, oxygen balance and consumption, sleep position, breathing effort, respiratory function, and audio, as well as recent progress in the implementation of data acquisition and processing and machine learning techniques that support early detection of severe OSA levels.

Sleep Disorders and Stroke: Does Treatment of Obstructive Sleep Apnea Decrease Risk of Ischemic Stroke?

PURPOSE OF REVIEW

This review aims to support obstructive sleep apnea (OSA) as a risk factor for ischemic stroke, review treatment strategies for OSA, provide a comprehensive review of clinical data on OSA treatment and ischemic stroke risk, and to critically assess if treatment of OSA decreases the risk of ischemic stroke and if treatment improves outcomes and subsequent ischemic stroke risk in post-stroke patients.

RECENT FINDINGS

Several observational studies, randomized controlled trials (RCTs), and meta-analyses have examined the risk of ischemic stroke and cardiovascular events in patients with OSA and have also examined continuous positive airway pressure (CPAP) treatment in these patients. Observational studies have shown an increased risk of ischemic stroke in patients with untreated OSA when compared with patients treated with CPAP; however, results are not statistically significant. RCTs and meta-analyses have shown no significant ischemic stroke risk reduction in CPAP treated patients with OSA. Several studies have shown improved outcomes in post-stroke patients with OSA treated with CPAP; however, few data is available for subsequent ischemic stroke risk reduction. Further research is needed for surgical treatment of OSA and assessment of ischemic stroke risk. OSA is associated with increased risk of ischemic stroke, and OSA should be treated with the appropriate therapy. While the current data is promising, more studies are necessary to state whether treatment of OSA reduces ischemic stroke risk and subsequent ischemic stroke risk. A practical approach to the sleep disorder evaluation and treatment of patients with cerebrovascular disease is outlined.