Enhancing Recovery in Stroke Survivors through Sleep Interventions: A Comprehensive Review

Sleep disorders are common complications following stroke, with a global meta-analysis indicating a prevalence as high as 53%. These disorders primarily include insomnia, obstructive sleep apnea (OSA), and circadian rhythm disruptions. By impairing neuroplasticity, exacerbating inflammatory responses, and interfering with the effectiveness of rehabilitation training, such disorders significantly delay neurological recovery, increase the risk of secondary stroke, and elevate the incidence of depression and anxiety. Consequently, they have become a critical factor limiting stroke rehabilitation. This article systematically reviews the application and progress of sleep interventions in stroke rehabilitation. A comprehensive literature search was conducted in PubMed, Web of Science, and CNKI databases from inception to December 2025, using keywords including "stroke," "sleep disorders," "sleep interventions," and "neurorehabilitation." Studies were included if they reported original data on sleep interventions in stroke patients, with no restrictions on study design. Data extraction and quality assessment were performed independently by two reviewers. Core strategies reviewed include cognitive behavioral therapy for insomnia (CBT-I), continuous positive airway pressure (CPAP), pharmacotherapy, and Traditional Chinese Medicine interventions such as acupuncture. Among these, CBT-I, as a first-line approach, has been shown to significantly improve sleep quality and emotional state when administered for over 8 weeks. CPAP can reduce the risk of recurrent vascular events by 55% in patients with OSA while also promoting neurocognitive recovery. Studies confirm that standardized sleep interventions, by optimizing sleep architecture and enhancing neural repair capacity, synergistically improve limb motor function and activities of daily living. Current research still faces challenges such as variable intervention adherence and insufficient mechanistic studies on non-OSA subtypes. Future efforts should rely on multidisciplinary collaboration to develop personalized intervention plans, incorporate novel technologies to optimize treatment strategies, further explore the clinical value of sleep interventions in stroke rehabilitation, and provide an evidence-based foundation for improving long-term patient prognosis.