ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1624631
Continuous positive airway pressure in acute ischemic stroke patients with obstructive sleep apnea: analysis of the National Inpatient Sample (NIS) database
Provisionally accepted
- 1Department of Neurology, Xiaolan People's Hospital of Zhongshan (The Fifth People's Hospital of Zhongshan), Zhongshan, China
- 2Department of Pediatric Orthopedic, Center for Orthopedic Surgery, the Third Affiliated Hospital of Southern Medical University, Guangzhou, China
- 3Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Background Obstructive sleep apnea (OSA) is an established independent risk factor for stroke. However, the efficacy of continuous positive airway pressure (CPAP) in patients with acute ischemic stroke and comorbid OSA (AIS-OSA) remains uncertain. This study aimed to assess the impact of CPAP on hospitalization outcomes for AIS-OSA patients using data from the National Inpatient Sample (NIS). Methods A retrospective data analysis was conducted using the NIS to identify patients hospitalized with a diagnosis of AIS-OSA between 2010 and 2019 with complete data. Patients were categorized into two groups based on CPAP treatment during hospitalization. Logistic regression analyses were performed to identify factors associated with CPAP treatment. Results Among 103,004 patients with AIS-OSA, those who received CPAP had statistically significant longer lengths of stay (LOS), higher medical expenses, and increased in-hospital mortality rates. Conversely, this group also exhibited higher proportions of routine discharges, suggesting potentially improved long-term outcomes. Independent predictors for CPAP treatment included advanced age, Black race, congestive heart failure, and obesity. Besides, factors such as pneumonia, acute myocardial infarction, pulmonary embolism, intracranial hemorrhage, thrombolysis, and mechanical thrombectomy may be associated with CPAP treatment, but this association does not imply causation. Conclusion This study identified independent predictors and associated factors for CPAP treatment in hospitalized AIS-OSA patients. Our observation may suggest that surviving patients who received CPAP treatment had more favorable prognoses, however, randomized trials are needed to determine causality.
Keywords: obstructive sleep apnea, Acute ischemic stroke, Continuous positiveairway pressure, outcomes, Nationwide Inpatient Sample, routine discharge
Received: 03 Jun 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Zeng, Zheng, Qi, Wang, He, Li, Xie and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qin Wang, angel880114@163.com
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