The sleep – wake cycle in the late stage of cerebral vascular accident recovery

Abstract

The sleep – wake cycle (SWC) stability and sleep quality in elderly are better preserved if social bonds are kept, whereas social isolation, or absence of a structured daily schedule, contribute to make them worse. Clinical disorders and medicine use also contribute to sleep problem complaints. This study was conducted with patients who had cerebral vascular accident (CVA) in order to evaluate the sleep – wake cycle condition, considering factors such as conditions of living and health, sleep habits, sleep and wake up times and frequency and duration of naps during weekdays as well as weekends. In this study we evaluated 24 volunteers: 12 patients (5 women; 7 men) between 6 and 42 months post-stroke and 12 healthy subjects (7 women and 5 men) all of them aged 50 – 65 years old. The patients exhibited unilateral brain lesions (right or left sides) and made use of medicines. Data were collected by means of a daily sleep log where volunteers recorded the time they slept and woke up and of naps each day, during seven consecutive days. Sleep habits and the Pittsburgh Sleep Quality questionnaires were also applied. Data analysis indicated that living conditions (number of persons in the house and in the bedroom, noise and illumination levels in the bedroom) did not influence the sleep quality of patients. According to the Pittsburgh Sleep Quality Index 67% of patients showed bad sleep quality but only 33% of healthy subjects showed the same result. The sleep duration in patients (8 h 37 min ± 60 min) was statistically greater than in healthy subjects (7 h 15 min ± 85 min) with patients waking up later than healthy subjects. According to the results, the SWC is preserved in patients in the late stage of CVA recovery although it is different from that exhibited by healthy subjects. The difference is due to an increase in sleep duration that seems to compensate for the worse sleep quality, suggesting that patients have suffered behavioral adaptations in order to compensate for the impairments caused by the CVA.