Objective and subjective sleep problems and quality of life of rehabilitation in patients with mild to moderate stroke

ABSTRACT

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 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. Physical functions, depression, anxiety, quality of life, subjective insomnia, quality of sleep, and fatigue were assessed at about 20 days after stroke. Objective sleep parameters were also assessed using a wrist-worn Actiwatch.

Results: Patients with insomnia had greater sleep onset latencies (p = .001), wake after sleep onset (p = .005), awoke more frequently (p = .013), and slept less efficiency (p < .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 = .009), and total insomnia severity index (p < .001), total Epworth Sleepiness Scale (p < .001), the National Institute’s Health Stroke Scale (p = .004), the Modified Barthel Index (p = .034), and Screening Tests for Aphasia and Neurologic-Communication Disorders (p = .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.

KEYWORDS:

• Objective sleep parameters
• insomnia
• quality of life
• rehabilitation
• stroke
• Actiwatch2

Author Disclosures

We certify that no party with direct or indirect interest in the results of the research supporting this article has or will confer any benefit to us or any organization with which we are associated. In addition, we certify that all financial and material support provided for this research (e.g. NIH or NHS grants) is clearly identified on the title page of this manuscript.

Description of author’s roles

Kim WH and Joa KL designed the study, analyzed data, and wrote the paper. Bae JN supervised data collection and analysis. Yoo YH, Lim JY, Kang SG, and Jung HY collected the data and assisted with writing the paper.

Additional information

Funding

This work was supported by an INHA University Research Grant.