Abstract NS13: Post Stroke Depression and Fatigue are Independently Related to Sleep Disturbances in Acute and Sub-acute Stroke Patients

Abstract

Post-stroke sleep disturbances (PSSD) is common and is associated with unfavorable clinical outcomes. The purpose of this study was to evaluate the characteristics of PSSD and how depression and fatigue affect PSSD in hospitalized and 3 months post stroke patients. Methods: Patients who were hospitalized with stroke at the Asan Medical Center were evaluated. The duration and latency of nighttime sleep, the frequency of waking after sleep onset, and daytime sleepiness were evaluated during the hospitalization and also 3 months post stroke. An actigraph was also performed. The location, circulation and laterality of each lesion were determined using MRI. Depression and fatigue were assessed using the Beck Depression Inventory and the Fatigue Severity Scale, respectively. For environmental factors, the equipment used at the bedside, and the number of other patients in the same room in acute stage and the place of residence, and the number of other person sharing the room in chronic stage were recorded. Results: A total of 282 patients completed the study. The mean age of the patients was 62.3(± 12.76). Sixty (21.3%) reported sleep duration <6 h/night and 110 (39.0%) reported more daytime sleepiness than prior to the stroke. In 54 patients who wore actigraph, self-reported sleep duration was significantly correlated with time in bed measured with an actigraph ( r =.407, p =.002). Quality of nighttime sleep was independently related to cortical lesion location (p=.002), diabetes mellitus (p=.020), and depression (p<.001) whereas increased daytime sleepiness was independently associated with subcortical lesion location (p=.031), fatigue (p=.001), and quality of nighttime sleep (p=.001). In chronic stage, 151 patients completed the study. PSSD persisted in the majority of the patients (75%) and the related factors to PSSD were also similar as compared to those in acute stage. Conclusions: PSSD are common in acute and chronic stroke patients. . Although brain lesion and diabetes mellitus were associated with nighttime PSSD, depression was the most powerful factor predicting nighttime sleep disturbances. Post-stroke daytime sleep was more closely associated with fatigue and subcortical lesion location.