Abstract
The complaints regarding sleep problems have not been well identified after a stroke. The aim of this study was to investigate the predictive factors of sleep quality and insomnia complaints in patients with stroke. A total of 70 subjects, 40 patients (57 ± 7 years) and 30 healthy controls (52 ± 6 years) assessed by the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Habits Questionnaire took part in the study. The data were analyzed using the chi-square test, the Student's t-test and logistic regression analysis. On average, the patients showed poor sleep quality (patients: 6.3 ± 3.5; controls: 3.9 ± 2.2; p= 0.002) and insomnia complaint was the most prevalent (patients: 37.5%; controls: 6.7%; p= 0.007). The absence of insomnia complaint (OR= 0.120; 95%CI= 0.017-0.873; p= 0.036) and the decreased latency of sleep (OR= 0.120; 95%CI= 0.017-0.873; p= 0.036) were the protective factors of sleep quality. Female sex (OR= 11.098; 95%CI= 1.167-105.559; p= 0.036) and fragmented sleep (OR= 32.040; 95%CI= 3.236-317.261; p= 0.003) were the risk factors for insomnia complaint. We suggest that complaints of poor sleep quality and insomnia should be given priority assessment during clinical diagnosis of sleep disorders in stroke.
Highlights
Stroke, defined as a focal disturbance of cerebral function as a result of vascular alterations, is a pathology that represents a serious public health problem in Brazil, given that the country has the highest death rate by stroke in Latin America and that it is still neglected by the population and even by health professionals (Lotufo 2005, Pontes-Neto et al 2008, Coca et al 2008).In addition to physical and cognitive impair ment, the occurrence of sleep disorders is anThe diagnosis and treatment of sleep disorders is a field that has been expanding considerably in recent years, with studies on the physiology and physiopathology of sleep
The results obtained for the Pittsburgh Sleep Quality Index (PSQI) score suggest that the patients, on average, experience poor sleep quality and had a higher latency, duration, and daytime dysfunction compared with control subjects
This finding suggests that longer sleep duration is likely due to compensation for the poor sleep quality that these patients experience, indicating the possibility of behavioral modification after the cerebral lesion
Summary
Stroke, defined as a focal disturbance of cerebral function as a result of vascular alterations, is a pathology that represents a serious public health problem in Brazil, given that the country has the highest death rate by stroke in Latin America and that it is still neglected by the population and even by health professionals (Lotufo 2005, Pontes-Neto et al 2008, Coca et al 2008).In addition to physical and cognitive impair ment, the occurrence of sleep disorders is anThe diagnosis and treatment of sleep disorders is a field that has been expanding considerably in recent years, with studies on the physiology and physiopathology of sleep. The alterations in the amount, quality or regulation of sleep include: insomnia, hypersomnia, obstructive sleep apnea syndrome, restless legs syndrome, circadian rhythm disorders, which encompass, among others, jet lag, delayed and advanced sleep phase syndrome. The alterations in behavioral or physiological events that occur during sleep in general in specific stages of this sleep or in sleepwake transitions include: sleep walking, night terrors, nightmares, sleep-talking, teeth grinding, nocturnal enuresis and snoring, among others (AASM 2001). Studies on patients with stroke show the occurrence of disturbed sleep, the main disorder being obstructive sleep apnea syndrome, which occurs in 60% to 90% of patients (Koch et al 2007, Srijithesh et al 2011). Campos et al (2005) showed various episodes of dozing at different times and poor sleep quality in chronic stage stroke patients Complaints of insomnia and excessive daytime somnolence are found in this clinical population (Ferrea et al 2010). Campos et al (2005) showed various episodes of dozing at different times and poor sleep quality in chronic stage stroke patients
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