Sleep problems worsen health-related quality of life and participation during the first 12 months of stroke rehabilitation.
George Fulk, Pamela Duncan, Karen J Klingman
PMID 32602376WHAT IT FOUND
Stroke survivors who said a sleep problem moderately or quite a bit affected function reported worse mobility, daily activities, mood, memory, and participation during the first year.
The study did not show sleep caused these problems.
Key findings
01The proportion reporting a sleep problem with moderate-to-quite-a-bit impact on function remained approximately steady at 8% at 2 months, 8% at 6 months, and 9% at 12 months.
02At six and 12 months, the no sleep problem group differed from the moderate-to-quite-a-bit group on Stroke Impact Scale scores for mobility, emotion, and memory; participation and communication also differed at six months.
03The original intervention groups were distributed equally across the sleep problem groups at each time point.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Participants were not asked about prior sleep habits, pre-existing sleep disorder diagnoses, or history of sleep problems. The analysis was cross-sectional, so it cannot show that sleep problems caused worse outcomes. The study did not know whether participants were assessed or treated for sleep disorders. No baseline sleep data were available, so early sleep problems could not be related to later recovery. The original study had only one sleep question and one impact rating, so it did not identify the type of sleep problem.
Declared interests
The authors declared no potential conflicts of interest. The original Locomotor Experience Applied Post-Stroke trial was sponsored by the US National Institutes of Health.
The easy way to misread this
Do not conclude that treating a sleep problem will improve stroke recovery. This analysis compared people who reported different sleep impact at separate time points; it did not test a sleep intervention.