Objective: The principal objectives of this study were to investigate relationships between objective sleep parameters that is, sleep onset latency, wake after sleep onset, number of awakenings, sleep efficiency, and sleep duration, and the quality of life after mild to moderate stroke.
Methods: The subjects were 112 first-time mild to moderate stroke patients admitted to a rehabilitation unit. At about 20 days after stroke, physical functions, depression, anxiety, quality of life, subjective insomnia, quality of sleep, and fatigue were assessed. Objective sleep parameters were also assessed using wrist worn actiwatch. Data from Actiwatches were analyzed over 30-second epochs using Actiwatch 8.0 software (Philips Respironics, Oregon, United States). Actiwatch measures total sleep duration, sleep onset latency, sleep efficiency, wake after sleep onset, and number of awakenings. Subjective insomnia was evaluated using the insomnia severity index. Quality of sleep was evaluated using the Pittsburgh Sleep Quality Index, which is a self-report questionnaire consisting of 19 items that include the seven components sleep duration, sleep onset, subjective sleep quality, sleep duration, daily sleep efficiency, sleep-related problems, sleep-associated drug use, and daytime dysfunctions during the previous month.
Results: Patients with insomnia had greater sleep onset latency (p=0.001), wake after sleep onset (p=0.005), awoke more frequently (p=0.013), and slept less efficiency (p<0.001) than patients without insomnia, but total sleep durations were similar. In all participants, lower overall domain of quality of life was significantly associated with sleep onset latency (p=0.009), and total insomnia severity index (p<0.001), total Epworth Sleepiness Scale (p<0.001), the National Institute’s Health Stroke Scale (p=0.004), Modified Barthel Index (p=0.034), and Screening Tests for Aphasia and Neurologic-Communication Disorders (p=0.044) scores.
Conclusion: Objective sleep parameters (sleep onset latency and sleep efficiency) were found to be associated with quality of life during the early stage of rehabilitation in mild to moderate stroke patients.
|
|
TABLE 1. Differences between Demographic and Clinical Variables, Physical Function, Depression, and Anxiety in Stroke Patients with or without Subjective Insomnia
TABLE 2. Difference between Sleep Parameter and Quality of Life in Stroke Patients with or without Subjective Insomnia
Table 3. Linear Regression Analysis of Demographic and Clinical Variables for Quality of Life
|
