Sleep Health During Recovery After Stroke

Abstract

Study objectives: People with stroke are susceptible to developing sleep disorders, which may negatively impact recovery. Little is known about sleep health (SH) broadly and its impact on recovery after stroke. The purpose of this study was to explore factors that are associated with SH during recovery after stroke.

Methods: Data were collected from 90 participants at 10-, 60-, and 90-days post stroke without moderate to severe obstructive sleep apnea. Sleep health was measured by combining data from actigraphy and self-report to create an SH score that reflected regularity, satisfaction, alertness, timing, efficiency, and duration of sleep. Factors that may be associated with SH that were collected were Patient Health Questionnaire 9 (PHQ-9), Montreal Cognitive Assessment (MOCA), Barthel Index (BI), gait speed (GS), oxygen desaturation index (ODI), age, and sex. A cumulative link mixed model (CLMM) was used to determine the association between SH and the independent factors.

Results: The CLMM found that the PHQ-9 had a significant negative estimate of-0.116 (p = 0.0002) and that the BI had a significant estimate of 0.016 (p = 0.044). Indicating that higher depressive symptoms and lower functional ability are associated with poorer SH. Time post stroke was not associated with SH.

Discussion: We identified depression and functional ability as significant determinants of SH. Participants exhibited poor SH while in the hospital and it remained unchanged at 60 and 90 days after stroke. Further evaluation of the likely bidirectional relationship between depression/functional impairment and SH after stroke may lead to targets to improve stroke recovery and SH.