What is the recommendation regarding screening for obstructive sleep apnea (OSA) in patients with ischemic stroke?
Routine screening of patients with recent ischemic stroke for obstructive sleep apnea (OSA) is not recommended. Numerous studies have established an association between OSA and stroke. Continuous positive airway pressure (CPAP) remains the most effective medical therapy for OSA, however, a small randomized controlled trial of CPAP in 127 patients found mixed results and the SAVE RCT (Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea to Prevent Cardiovascular Disease) randomized 2717 patients with established cardiovascular or cerebrovascular disease and moderate to severe OSA to CPAP versus usual care without CPAP and found no reduction of vascular events, including stroke, in patients treated with CPAP over a mean follow-up of Thus, the routine screening for OSA of all patients with AIS for the secondary prevention of cardiovascular events or death is not recommended at this time.