Distinctive Features of Obstructive Sleep Apnea in Chinese Patients With Acute Cerebral Infarction: A Prospective Observational Study

Background Obstructive sleep apnea (OSA) is a modifiable risk factor that benefits from timely detection and treatment to improve poststroke outcomes, yet ethnic‐specific features and practical screening strategies remain undercharacterized. We evaluated OSA prevalence, its association with neurocognitive function, and screening performance in Chinese patients with acute cerebral infarction. Methods In this prospective cohort, 183 consecutive Han Chinese inpatients with acute cerebral infarction underwent home sleep apnea testing within 2 weeks of onset. Moderate to severe OSA was defined as an apnea–hypopnea index ≥15 events/h. Neurocognitive function was assessed by Mini‐Mental State Examination and National Institutes of Health Stroke Scale. The diagnostic performance of the STOP‐Bang questionnaire, including sensitivity, specificity, positive predictive value, and negative predictive value, was evaluated for identifying moderate to severe OSA. Results OSA prevalence was 79.2%, with 37.7% moderate to severe. Cognitive impairment (Mini‐Mental State Examination <23) was less frequent in patients without OSA than patients with OSA (15.8% versus 31.3%–40.8%, P =0.048). Sex‐stratified analyses showed higher cognitive impairment burden in women comparing non‐OSA versus mild OSA ( P =0.040), with no parallel association observed in men (all P =0.400). STOP‐Bang had limited discrimination (area under the receiver operating characteristic curve, 0.72), with high sensitivity (88.4%) but low specificity (39.5%). Conclusions Chinese patients with acute cerebral infarction have a high OSA burden. Sex‐stratified results suggest potential female‐specific vulnerability to OSA‐related cognitive impairment, warranting larger cohorts. Given limited specificity and triage value of STOP‐Bang, objective sleep apnea evaluation should be performed whenever feasible in this population. Registration URL: https://www.chictr.org.cn/ . Identifier: ChiCTR2000038312.