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Mapping the Evidence: Central Sleep Apnea Syndromes During Sleep and Stroke-A Scoping Review
Karol Uscamaita1,2, Imán Yazbeck Morell3, María-José Sánchez-López4
1Neurology Service, Sleep Disorders Unit, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, 08029 Barcelona, Spain.
Revista De Neurologia
|May 30, 2026
Summary
Central sleep apnea (CSA) is significantly more common after ischemic stroke than in the general population. This review highlights its prevalence, potential links to cerebrovascular risk, and the need for standardized diagnostic criteria.
Area of Science:
- Neurology
- Sleep Medicine
- Cardiovascular Research
Background:
- Central sleep apnea (CSA) and ischemic stroke share a complex, bidirectional relationship.
- Post-ischemic stroke CSA prevalence is markedly higher (8-12%) than in the general population (<1%).
- Estimates of CSA frequency in stroke cohorts are heterogeneous due to differing diagnostic criteria.
Purpose of the Study:
- To review the evidence on central sleep apnea (CSA) syndromes in patients with ischemic stroke.
- To summarize CSA prevalence, underlying mechanisms, clinical correlations, and prognostic implications.
- To map the existing literature on CSA and stroke.
Main Methods:
- A systematic scoping review of observational and interventional studies.
- Searched Medline (PubMed), Scopus, Cochrane Reviews, and Web of Science databases.
- Data extraction by two independent reviewers focusing on study design, stroke characteristics, CSA definitions, comorbidities, and outcomes.
Main Results:
- Fifty-five studies involving thousands of ischemic stroke patients were analyzed.
- Post-stroke CSA prevalence ranged from 8% to 12%, exceeding general population rates.
- CSA in stroke patients often occurred without overt cardiac issues and was associated with lower BMI and fewer cardiovascular risk factors compared to obstructive sleep apnea.
Conclusions:
- Central sleep apnea (CSA) syndromes are substantially more frequent in ischemic stroke patients.
- CSA may be linked to increased cerebrovascular risk and subclinical brain injury.
- Standardized criteria and prospective studies are crucial to define CSA's role in stroke.
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The condition is more prevalent among...
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An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
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