Depression is a powerful predictor of nighttime sleep disturbances among stroke survivors, according to research presented at the Nursing Symposium of the American Stroke Association’s International Stroke Conference 2015.
Sleep disturbances – the duration and time intervals of nighttime sleep, the frequency of waking after sleep onset, and daytime sleepiness – are common and are associated with poor health after stroke.
Researchers studied how depression and fatigue affect sleep disturbance in patients hospitalized with stroke and three months after stroke. More than one-fifth of the total 282 patients studied while hospitalized reported sleep duration of less than six hours a night.
Of the 199 patients who completed the study at three months, 44 percent continued to suffer nighttime sleep disturbances. Depression was the most powerful factor related to nighttime sleep disturbance, whereas, excessive daytime sleepiness was associated with fatigue, brain lesion size and female gender. They also found:
- Thirty-nine percent reported more daytime sleepiness than prior to stroke.
- In 54 patients who were monitored using a device, their nighttime sleep quality was impacted by where the stroke occurred in the cerebral cortex, part of the brain associated with sensory and motor function and depression.
- While increased daytime sleepiness was most associated with subcortical lesion location and fatigue, quality of nighttime sleep also had an impact. Subcortical strokes occur when small, intricate arteries deep within the brain are affected.