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Sleep electroencephalogram changes in acute hemispheric stroke.

C L. Bassetti1, M S. Aldrich

  • 1Department of Neurology, University Hospital-Inselspital, 3010, Berne, Switzerland

Sleep Medicine
|April 20, 2001
PubMed
Summary
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Acute hemispheric stroke impacts sleep architecture, affecting total sleep time and efficiency. These sleep changes over the healthy hemisphere correlate with stroke severity, suggesting hemispheric control of sleep.

Area of Science:

  • Neuroscience
  • Sleep Medicine
  • Neurology

Background:

  • Limited and conflicting data exist on how cerebral hemispheric stroke affects sleep architecture.
  • Previous studies have not prospectively investigated supratentorial, extra-thalamic strokes.

Purpose of the Study:

  • To prospectively investigate the effects of acute supratentorial, extra-thalamic stroke on sleep architecture.
  • To correlate sleep changes with stroke severity and patient outcomes.

Main Methods:

  • 24 patients with first acute supratentorial, extra-thalamic stroke underwent brain MRI and sleep EEG.
  • Sleep EEGs were scored for sleep stages, spindles, and sawtooth waves, comparing stroke patients to 17 healthy controls.
  • Stroke severity, topography, and volume were assessed.

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Main Results:

  • Stroke patients exhibited reduced total sleep time, lower sleep efficiency, and decreased NREM sleep stages 2-4 compared to controls.
  • Reduced sleep spindles and sawtooth waves were observed in patients with larger stroke volumes (>25 ml).
  • Good patient outcomes correlated with higher sleep efficiency and more sleep time.

Conclusions:

  • Acute hemispheric stroke causes significant sleep EEG changes, even over the unaffected hemisphere.
  • These sleep alterations correlate with stroke severity, supporting the role of cerebral hemispheres in sleep regulation.
  • Sleep architecture changes may serve as a biomarker for stroke outcome.