Abstract Number: Esoc2026a2505 Impact of Continuous Positive AIrway Pressure Therapy on Neurological and Functional Recovery in Stroke Patients With Obstructive Sleep Apnea: A Scoping Review

Abstract Background and aims Obstructive sleep apnea (OSA) is a prevalent comorbidity in stroke patients that negatively impacts neurological recovery. This scoping review evaluates the effects of continuous positive airway pressure (CPAP) therapy on post-stroke neurological, motor, and cognitive outcomes. Methods A systematic search of the PubMed database was conducted to identify randomized controlled trials and prospective clinical studies evaluating CPAP therapy in adults with OSA following ischemic stroke or TIA. Five studies (N=318) met the inclusion criteria. Key outcomes included neurological deficit scores (NIHSS, CNS, mRS), motor function (Fugl–Meyer, FIM), and cognitive performance. Due to methodological heterogeneity, a scoping approach with narrative synthesis was performed. Results Most studies reported significantly greater improvements in neurological deficit scores (NIHSS and CNS) with CPAP therapy compared to control or sham groups. Global functional recovery at one-year follow-up (mRS) was significantly higher in the CPAP group (53% vs 27%, p=0.03). CPAP treatment was also associated with significant benefits in cognitive domains, particularly attention, executive function, and cognitive independence (p0.05). Furthermore, evidence suggested that regular CPAP use may reduce the risk of recurrent vascular events within the first year (p=0.02). Mean CPAP adherence ranged from 2.5 to 3.8 hours/night and was positively correlated with clinical outcomes. Conclusions CPAP therapy may support neurological, motor, and cognitive recovery in stroke patients with coexisting OSA. However, findings should be interpreted cautiously due to methodological heterogeneity and variable treatment adherence. Larger, well-designed trials are needed to confirm the role of CPAP therapy in stroke rehabilitation. Conflict of interest Şeyma Nur Önal: Nothing to disclose.