PTOTCohortNeurorehabilitation and neural repair2021

Self-Reported and Objective Sleep Measures in Stroke Survivors With Incomplete Motor Recovery at the Chronic Stage.

Melanie K Fleming, Tom Smejka, David Henderson Slater and 3 others

PMID 34196598

WHAT IT FOUND

Chronic stroke survivors report worse sleep and spend more time awake overnight than healthy controls.

However, sleep quality does not correlate with upper limb motor impairment or time since stroke. Depressive symptoms are a stronger predictor of perceived sleep problems than physical disability.

Key findings

01Stroke survivors had significantly poorer self-reported sleep and spent more time awake overnight compared to controls.

02Neither upper limb motor impairment nor time since stroke explained variance in sleep measures.

03Depressive symptoms explained 20% of the variance in self-reported sleep quality across both groups.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study did not assess lower limb motor impairment, so it remains unclear if sleep issues relate to mobility or gait. No data on stroke severity, lesion location, or cognitive impairment were collected, which could influence sleep. The sample consisted of community-dwelling survivors, mostly years post-stroke, limiting generalisability to acute or sub-acute populations. Fatigue was not measured, despite being a common post-stroke complication that may mediate the relationship between impairment and sleep.

Declared interests

The authors declared no conflicts of interest. Funding was provided by the Wellcome Trust and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre.

The easy way to misread this

Do not interpret the lack of correlation between motor impairment and sleep as evidence that physical therapy cannot improve sleep. The study only looked at upper limb function and did not assess lower limb mobility or fatigue, which may play a larger role in sleep quality.

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