{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:48:25Z","timestamp":1792601305862,"version":"4.5.0"},"reference-count":335,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Sleep disorders and stroke are intricately linked through a complex, bidirectional relationship. Sleep disturbances such as obstructive sleep apnea (OSA), insomnia, and restless legs syndrome (RLS) not only increase the risk of stroke but also frequently emerge as consequences of cerebrovascular events. OSA, in particular, is associated with a two- to three-fold increased risk of incident stroke, primarily through mechanisms involving intermittent hypoxia, systemic inflammation, endothelial dysfunction, and autonomic dysregulation. Conversely, stroke can disrupt sleep architecture and trigger or exacerbate sleep disorders, including insomnia, hypersomnia, circadian rhythm disturbances, and breathing-related sleep disorders. These post-stroke sleep disturbances are common and significantly impair rehabilitation, cognitive recovery, and quality of life, yet they remain underdiagnosed and undertreated. Early identification and management of sleep disorders in stroke patients are essential to optimize recovery and reduce the risk of recurrence. Therapeutic strategies include lifestyle modifications, pharmacological treatments, medical devices such as continuous positive airway pressure (CPAP), and emerging alternatives for CPAP-intolerant individuals. Despite growing awareness, significant knowledge gaps persist, particularly regarding non-OSA sleep disorders and their impact on stroke outcomes. Improved diagnostic tools, broader screening protocols, and greater integration of sleep assessments into stroke care are urgently needed. This narrative review synthesizes current evidence on the interplay between sleep and stroke, emphasizing the importance of personalized, multidisciplinary approaches to diagnosis and treatment. Advancing research in this field holds promise for reducing the global burden of stroke and improving long-term outcomes through targeted sleep interventions.<\/jats:p>","DOI":"10.3390\/medsci13030113","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:44:32Z","timestamp":1754401472000},"page":"113","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Sleep Disorders and Stroke: Pathophysiological Links, Clinical Implications, and Management Strategies"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6179-2177","authenticated-orcid":false,"given":"Jamir Pitton","family":"Rissardo","sequence":"first","affiliation":[{"name":"Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Khalil","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Alexandria University, Alexandria 5372066, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7283-4103","authenticated-orcid":false,"given":"Mohamad","family":"Taha","sequence":"additional","affiliation":[{"name":"School of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4713-3780","authenticated-orcid":false,"given":"Justin","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Sayad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Assiut University, Assiut 71515, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8024-2354","authenticated-orcid":false,"given":"Ana Let\u00edcia","family":"Fornari Caprara","sequence":"additional","affiliation":[{"name":"Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1212\/WNL.0000000000003037","article-title":"Role of Sleep-Disordered Breathing and Sleep-Wake Disturbances for Stroke and Stroke Recovery","volume":"87","author":"Hermann","year":"2016","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1093\/sleep\/26.3.293","article-title":"Relationship of Sleep Apnea to Functional Capacity and Length of Hospitalization Following Stroke","volume":"26","author":"Kaneko","year":"2003","journal-title":"Sleep"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1212\/CPJ.0b013e318296f274","article-title":"Early Diagnosis and Treatment of Obstructive Sleep Apnea after Stroke: Are We Neglecting a Modifiable Stroke Risk Factor?","volume":"3","author":"Davis","year":"2013","journal-title":"Neurol. 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