Good sleep quality improves functional recovery during inpatient rehabilitation in stroke patients, according to a new study presented at the recently concluded American Stroke Association’s International Stroke Conference 2022.¹

Thirteen patients who were getting post-stroke inpatient rehabilitation were recruited for this study to investigate the relationship between functional recovery and sleep. More than half were women (54%); the mean age of the participants was 65 years and the mean time since the onset of stroke was 15.5 days.

The GG Self Care and Mobility scales were utilized to assess function at the time of hospitalization and discharge, while sleep was measured using sleep efficiency and wakefulness after sleep onset (WASO) parameters obtained via ActiGraph wGT3X-BT activity monitor (AGAM) worn by the patients for 5 days at admission.

A moderate association was observed between sleep efficiency and change in GG mobility score (r=0.67), while a moderate inverse association was noted between WASO and change in GG mobility scores. No significant association was noted between change in GG self-care score and sleep parameters.

Patients who spent less time awake after onset of sleep during the night, in the first 5 days of their inpatient rehabilitation stay, had better sleep efficiency.  These patients also were found show greater improvement in functional mobility at hospital discharge.

Stroke patients find it difficult to sleep. The duration of sleep as well as quality of sleep is adversely affected. Sleep has been shown to be important for neuroplasticity and recovery.²Â A stroke patient has to again acquire motor skills, gross and fine. This is also the goal of the physical rehabilitation in these patients.

A good quality sleep also boosts the body’s immune system. It has also been shown that impaired sleep induces a stress response in the body leading to production of pro-inflammatory cytokines creating a state of chronic low-grade inflammation with deleterious effects on health. Increase in total sleep time and interventions towards this end, may promote healing and better recovery of function 

Reference

1. Fulk G, et al. Better sleep is associated with improvement in functional mobility during inpatient rehabilitation after stroke. Stroke. 2022 Feb. 3; 53 (Suppl 1):AWP60. https://doi.org/10.1161/str.53.suppl_1.WP60.
2. Williams-Cooke C, et al. Association between sleep duration and functional disability in inpatient stroke rehabilitation: a pilot observational study. Arch Rehabil Res Clin Transl. 2021 Jul 26;3(3):100150. doi: 10.1016/j.arrct.2021.100150.