Is insomnia a long-term side effect of stroke?

Is insomnia a long-term side effect of stroke?

Stroke patients experience long-term issues with insomnia, which puts them at an increased risk of depression and limits their ability to learn new skills, a new study suggests.

In a joint study comprising researchers from the University of Surrey, UK, University of Freiburg, Germany, and the University of Bern, Switzerland, a depth sleep lab experiment was conducted to compare brain signals of patients who were at one year post-stroke and the general population. This would help understand the link between insomnia and stroke.

Although the association difficulty sleeping has with those who have had stroke is known, there is little information about the brain signals underlying poor sleep, in particular amongst individuals who have returned to regular living.

Assessing the brain’s sleep pattern

The researchers used a polysomnogram (PSG), which assessed the brain’s sleeping patterns over two nights, and found that it took stroke patients longer to fall asleep and that they had poorer sleep efficiency.

A multiple sleep test (MSLT) was also used and showed that stroke patients were less likely to nap or fall asleep during the day to compensate for lost sleep at night. It was also found that they were more susceptible to mistakes in a vigilance test than their non-stroke counterparts, increasing risk of cognitive failures or falls.

Researchers found that although sleep efficiency was reduced in patients, the total time sleeping between the groups was similar. This suggests that it is unlikely that insomnia is caused by lesions in the brain’s centres for sleep-wake regulation.

It is believed that sleep problems experienced by stroke patients are due to such contributory factors as:

  • Greater psychological strain;
  • Pain and discomfort; and
  • Reduced levels of physical activity.

Aiding the recovery of patients

Annette Sterr, professor of cognitive neuroscience and neuropsychology at Surrey University, said: “Our research shows that those who have suffered from stroke maintain difficulties with their sleep, which is likely to affect the overall recovery and quality of life.

“The importance of sleep in aiding the recovery of patients should not be underestimated in helping to improve and maintain physical and mental wellbeing.”

She added: “Presently, sleep is not considered in the NICE guidelines for stroke rehabilitation, an issue we hope will be revisited by the organisation in due course. Harnessing the power of good sleep is likely to maximise recovery and quality of life.”

Press release: University of Surrey

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