Relationships between sleep efficiency and physical activity after stroke: a cross-sectional study

Stroke patients are prone to reduced daytime physical activity (PA) and poor nighttime sleep quality. Sleep may influence daytime PA; however, few studies have examined this relationship using objective assessments. This study aimed to investigate the association between PA and sleep among stroke patients in a convalescent rehabilitation ward.

This was a cross-sectional study of stroke patients. PA and sleep were measured using a wearable device. PA was categorized into sedentary behavior (SB), light physical activity (LPA), and moderate to vigorous physical activity (MVPA). Sleep was assessed using sleep efficiency (SE), defined as the percentage of time spent asleep while in bed. Associations between SE and each PA parameter were analyzed using correlation and multiple regression analyses.

A total of 76 patients (mean age 70.0 ± 12.0 years, 41 males) were analyzed. Median SE was 85.3% (interquartile range [IQR]: 81.2-89.0). The mean duration of daytime PA was 195.2 ± 67.5 min/day for SB, 319.5 ± 46.9 min/day for LPA, and 79.8 (IQR: 50.7-103.1) min/day for MVPA. SE was significantly correlated with MVPA (ρ = 0.330, p = 0.003). In multiple regression analysis, SE was negatively associated with SB (B =  -2.427, β =  -0.268, p = 0.036) and positively associated with MVPA (B = 1.573, β = 0.246, p = 0.041).

In stroke patients undergoing convalescent rehabilitation, SE was associated with SB and MVPA. These findings suggest that improving SE may reduce SB and increasing MVPA during inpatient rehabilitation.