Sleep Disturbances at 3 Months after Cerebral Infarction

Post-stroke sleep disturbances (PSSD) are common and associated with various adverse outcomes. However, PSSD in the sub-acute stages of stroke have been scarcely studied. We aimed to evaluate the characteristics of and the factors related to PSSD in stroke patients 3 months post stroke.

A total of 199 patients were evaluated for PSSD at 3 months after stroke. The qualities of nighttime sleep and excessive daytime sleepiness (EDS) were assessed using the Verran Snyder-Halpern sleep scale and Epworth Sleepiness Scale, respectively. Presence of motor dysfunction and post-stroke pain, post-stroke depression, fatigue and social support were evaluated.

Eighty-eight patients (44.2%) had poor quality of nighttime sleep. Twenty-eight patients (14.4%) reported EDS. Poor quality of nighttime sleep was independently associated with depression (p = 0.044) and EDS (p = 0.041) whereas fatigue (p < 0.001) and poor nighttime sleep (p = 0.045) were independently associated with EDS. Post-stroke pain and social support showed no association with PSSD.

We found that the occurrence of PSSD 3 months after stroke is common. Although causality remained to be determined, depression and nighttime sleep disturbances were related, whereas fatigue and nighttime sleep disturbances were related to EDS.