Advertisement
Research Article| Volume 25, ISSUE 3, P727-732, March 2016

Factors Affecting Poststroke Sleep Disorders

  • Burcu Karaca
    Correspondence
    Address correspondence to Burcu Karaca, MD, Department of Physical Medicine and Rehabilitation, Kırıkkale University Faculty of Medicine, Kırıkkale Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi Kırıkkale Üniversitesi Kampüsü Ankara Yolu 7.Km., 71450, Yahşihan, Kirikkale, Turkey.
    Affiliations
    Department of Physical Medicine and Rehabilitation, Kırıkkale University Faculty of Medicine, Yahşihan, Kirikkale, Turkey
    Search for articles by this author

      Objective

      The aim of this study is to evaluate the sleep quality of stroke patients, to present the influencing factors, and thus to provide more effective rehabilitation in hospitals' inpatient clinics.

      Materials and Methods

      Twenty-three stroke patients who received inpatient treatment at Bolu Physical Therapy and Rehabilitation Hospital were retrospectively evaluated in the study. Educational background, occupation, body mass index, symptom duration, etiology, dominant hemisphere, affected hemisphere, comorbid diseases, and Brunnstrom recovery stages (9), Pittsburgh Sleep Quality Index (PSQI) score, Beck Depression Inventory (BDI) score, and Functional Independence Measure score were assessed.

      Results

      In multivariate linear regression analysis, we found that BDI score (P = .030) and comorbid diseases (P = .040) had the highest effect on change in PSQI.

      Conclusions

      Depression and comorbid diseases were the most effective factors on poststroke sleep disorder in patients who underwent neurological rehabilitation and they should be managed to increase the efficacy of the neurological rehabilitation.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Brandstater M.E.
        Stroke rehabilitation.
        in: DeLisa J.A. Gans B.M. Rehabilitation medicine. Lippincott-Raven Publishers, Philadelphia1998: 1165-1189
        • Soler E.P.
        • Ruiz V.C.
        Epidemiology and risk factors of cerebral ischemic heart diseases: similarities and differences.
        Curr Cardiol Rev. 2010; 6: 138-149
        • Leppavuori A.
        • Pohjasvaara T.
        • Vataja R.
        • et al.
        Insomnia in ischemic stroke patients.
        Cerebrovasc Dis. 2002; 14: 90-97
        • Pasic Z.
        • Smajlovic D.
        • Dostovic Z.
        • et al.
        Incidence and types of sleep disorders in patients with stroke.
        Med Arh. 2011; 65: 225-227
        • Bassetti C.L.
        Sleep and stroke.
        Semin Neurol. 2005; 25: 19-32
        • Choi-Kwon S.
        • Han K.
        • Choi S.
        • et al.
        Poststroke depression and emotional incontinence: factors related to acute and subacute stages.
        Neurology. 2012; 78: 1130-1137
        • Choi-Kwon S.
        • Kim J.S.
        Poststroke fatigue: an emerging, critical issue in stroke medicine.
        Int J Stroke. 2011; 6: 328-336
        • Ferre A.
        • Ribo M.
        • Rodriguez-Luna D.
        • et al.
        Strokes and their relationship with sleep and sleep disorders.
        Neurologia. 2013; 28: 103-118
        • Brunnstrom S.
        Motor testing procedures in hemiplegia: based on sequential recovery stages.
        Phys Ther. 1966; 46: 357-375
        • Buysse D.J.
        • Reynolds C.F.
        • Monk T.H.
        • et al.
        The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.
        Psychiatry Res. 1989; 28: 193-213
        • Ağargün M.Y.
        • Kara H.
        • Anlar O.
        Pittsburgh Uyku Kalitesi indeksinin geçerliği ve güvenirliği.
        Türk Psikiyatri Derg. 1996; 7: 107-115
        • Beck A.T.
        • Steer R.A.
        • Garbin M.G.
        Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation.
        Clin Psychol. 1988; 8: 77-100
        • Dromerick A.W.
        • Edwards D.F.
        • Diringer M.N.
        Sensitivity to changes in disability after stroke: a comparison of four scales useful in clinical trials.
        J Rehabil Res Dev. 2003; 40: 1-8
        • Küçükdeveci A.A.
        • Yavuzer G.
        • Elhan A.H.
        • et al.
        Adaptation of the Functional Independence Measure for use in Turkey.
        Clin Rehabil. 2001; 15: 311-318
        • Palomäki H.
        • Berg A.
        • Meririnne E.
        • et al.
        Complaints of poststroke insomnia and its treatment with mianserin.
        Cerebrovasc Dis. 2003; 15: 56-62
        • Pohjasvaara T.
        • Leppavuori A.
        • Siira I.
        • et al.
        Frequency and clinical determinants of poststroke depression.
        Stroke. 1998; 29: 2311-2317
        • Chemerenski E.
        • Robinson R.G.
        The neuropsychiatry of stroke.
        Psychosomatics. 2000; 41: 5-14
        • Tang W.K.
        • Chan S.S.
        • Chiu H.F.
        • et al.
        Poststroke depression in Chinese patients: frequency, psychosocial, clinical, and radiological determinants.
        J Geriatr Psychiatry Neurol. 2005; 18: 45-51
        • Johnson J.L.
        • Minarik P.A.
        • Nystrom K.V.
        • et al.
        Poststroke depression incidence and risk factors: an integrative literature review.
        J Neurosci Nurs. 2006; 38: 316-327
        • Chen Y.K.
        • Lu J.Y.
        • Mok V.C.
        • et al.
        Clinical and radiologic correlates of insomnia symptoms in ischemic stroke patients.
        Int J Geriatr Psychiatry. 2011; 26: 451-457
        • Da Rocha P.C.
        • Barroso M.T.
        • Dantas A.A.
        • et al.
        Predictive factors of subjective sleep quality and insomnia complaint in patients with stroke: implications for clinical practice.
        An Acad Bras Cienc. 2013; 85: 1197-1206
        • Bassetti C.L.
        • Milanova M.
        • Gugger M.
        Sleep-disordered breathing and acute ischemic stroke: diagnosis, risk factors, treatment, evolution, and long-term clinical outcome.
        Stroke. 2006; 37 (Epub 2006 Mar 16): 967-972
        • Katz D.A.
        • McHorney C.A.
        Clinical correlates of insomnia in patients with chronic illness.
        Arch Intern Med. 1998; 158: 1099-1107
        • Su T.P.
        • Huang S.R.
        • Chou P.
        Prevalence and risk factors of insomnia in community-dwelling Chinese elderly: a Taiwanese urban area survey.
        Aust NZ J Psychiat. 2004; 38: 706-713
        • Suh M.
        • Choi-Kwon S.
        • Kim J.S.
        Sleep disturbances after cerebral infarction: role of depression and fatigue.
        J Stroke Cerebrovasc Dis. 2014; 23: 1949-1955
        • Kim J.S.
        • Choi-Kwon S.
        Poststroke depression and emotional incontinence: correlation with lesion location.
        Neurology. 2000; 54: 1805-1810
        • Hayashino Y.
        • Yamazaki S.
        • Takegami M.
        • et al.
        Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh Sleep Quality Index: results from a population-based survey.
        Sleep Med. 2010; 11: 366-371
        • Wallace D.M.
        • Ramos A.R.
        • Rundek T.
        Sleep disorders and stroke.
        Int J Stroke. 2012; 7: 231-242
        • Curcio G.
        • Ferrara M.
        • De Gennaro L.
        Sleep loss, learning capacity and academic performance.
        Sleep Med Rev. 2006; 10: 323-337
        • Wright Jr, K.P.
        • Hull J.T.
        • Hughes R.J.
        • et al.
        Sleep and wakefulness out of phase with internal biological time impairs learning in humans.
        J Cogn Neurosci. 2006; 18: 508-521
        • Ebrahim S.
        • Barer D.
        • Nouri F.
        Use of the Nottingham Health Profile with patients after a stroke.
        J Epidemiol Community Health. 1986; 40: 166-169
        • Hermann D.M.
        • Bassetti C.L.
        Sleep-related breathing and sleep-wake disturbances in ischemic stroke.
        Neurology. 2009; 73: 1313-1322
        • Terzoudi A.
        • Vorvolakos T.
        • Heliopoulos I.
        • et al.
        Sleep architecture in stroke and relation to outcome.
        Eur Neurol. 2009; 61: 16-22
        • Kim J.
        • Kim Y.
        • Yang K.I.
        • et al.
        The relationship between sleep disturbance and functionalstatus in mild stroke patients.
        Ann Rehabil Med. 2015; 39: 545-552