Impact of Sleep-Disordered Breathing on Outcomes of Ischemic Stroke: A Systematic Review and Meta-Analysis

Sleep-disordered breathing (SDB) is common in ischemic stroke patients and may influence recovery and long-term outcomes. This systematic review and meta-analysis aims to evaluate the impact of SDB on clinical outcomes of ischemic stroke including complications, cognitive impairment, hospitalization, recurrent stroke, and mortality. A systematic search of PubMed, Embase, and Scopus databases was conducted to identify observational studies examining the relationship between SDB and outcomes in ischemic stroke patients. Random-effect models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic. A total of 30 observational studies were included. SDB was associated with significantly higher odds of hospitalization (OR: 6.14, 95% CI: 1.35-27.97) and mortality (OR: 3.39, 95% CI: 1.15-9.98). Moderate-to-severe SDB (AHI > 15) was linked to a higher incidence of adverse outcomes (OR: 1.03, 95% CI: 1.01-1.05). However, no significant associations were found for cognitive impairment (OR: 1.05, 95% CI: 0.73-1.51), complications (OR: 1.14, 95% CI: 0.84-1.55), or recurrent stroke (OR: 1.02, 95% CI: 0.19-5.47). SDB significantly increases the risk of hospitalization and mortality in ischemic stroke patients. Early identification and management of SDB could improve clinical outcomes, though further research is needed to explore causal relationships and optimize interventions.Prospero Registration Number: CRD42024612023.