Obstructive Sleep Apnea Syndrome and Ischemic Stroke: Investigating Inflammatory Mechanisms

Zihao Zhang,1,2 Ziqing Zhu,1,2 Zhiying Chen,2,3 Xiaoqun Liu,1,2 Wenmin Yu,4,5 Toheed Aqdas,6 Rui Yuan7 1Department of Respiratory and Critical Care, School of Clinical Medicine, Jiujiang University, Jiujiang, Jiangxi, 332000, People’s Republic of China; 2Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi, 332000, People’s Republic of China; 3Department of Neurology, School of Clinical Medicine, Jiujiang University, Jiujiang, Jiangxi, 332000, People’s Republic of China; 4Jiangxi Provincial Key Laboratory of Cell Precision Therapy, Jiujiang University, Jiujiang, Jiangxi, 332000, People’s Republic of China; 5The School of Basic Medical Science, Jiujiang University, Jiujiang, Jiangxi, 332000, People’s Republic of China; 6Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, 332000, People’s Republic of China; 7Faculty of International Studies, Jiujiang University, Jiujiang, Jiangxi, 332005, People’s Republic of ChinaCorrespondence: Rui Yuan, Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, 332000, People’s Republic of China, Email [email protected]: Obstructive Sleep Apnea Syndrome (OSAS) is characterized by repeated episodes of complete (apnea) or partial (hypopnea) collapse of the upper airway during sleep, leading to chronic intermittent hypoxia and/or hypercapnia, and sleep fragmentation. This review systematically examines the mechanisms linking OSAS and ischemic stroke, with particular emphasis on the roles of the PI3K/Akt signaling pathway, Toll-like receptor signaling pathway, and NLRP3 inflammasome in OSAS-related inflammatory responses, and their contributions to the pathogenesis and progression of ischemic stroke. We also explore how OSAS affects stroke recovery through impaired sleep quality and increased cardiovascular stress, potentially worsening prognosis. This article discusses potential anti-inflammatory therapeutic strategies, underscores the importance of early OSAS intervention in reducing recurrence and improving outcomes, and offers new perspectives on OSAS-related ischemic stroke mechanisms and clinical management.Keywords: obstructive sleep apnea syndrome, ischemic stroke, inflammatory mechanisms, signalling pathways