Abstract P204: Stroke Topography Impacts Sleep Architecture in Post-Acute Stroke

Abstract

Introduction/Objective: Sleep-wake disturbances (SWDs) are common amongst stroke patients; however, little work has been done on the effect of stroke location on sleep architecture. The aim of this study was to investigate the impact of stroke topography on prevalence and severity of SWDs in the post-acute phase of ischemic stroke recovery. Methods: Ischemic stroke patients (n=55) were assessed for SWDs via overnight attended polysomnography in a post-acute rehabilitation setting. The mean age was 55 ± 1.4 years and mean latency from injury was 106 ± 11 days. Sleep measures included total sleep time (TST), sleep and REM latency, sleep efficiency, percent time in sleep stages, apnea/hypopnea index (AHI), wake after sleep onset (WASO), and arousal index. Patients who did not have at least four hours of TST were excluded. Stroke patients were identified as having supratentorial or infratentorial injuries. Results: Results showed a significant difference between supratentorial and infratentorial stroke in regards to sleep efficiency, REM sleep, and sleep apnea. Patients with infratentorial stroke (n=15) displayed significantly poorer sleep efficiency (F(1,53)=12.386, p<.001), decreased REM sleep (F(1,53)=5.944), p<.05) and higher AHI (F(1,53)=4.698, p<.05). In addition to displaying a decreased amount of REM, infratentorial stroke patients displayed significantly shorter bouts of REM (F(1,52)=7.482, p<.01). Neither age nor AHI were significantly correlated with the amount or duration of REM (p>.05). Conclusion: Infratentorial ischemic stroke patients display significant disruptions in sleep and may require close monitoring for sleep-wake disturbances in the post-acute period. REM sleep is particularly effected when compared to supratentorial ischemic stroke.