Sleep dysfunction in stroke survivors impacts caregiver burden and functional recovery-an observational study.

Abstract

Purpose: Sleep dysfunction is often reported post-stroke, but its impact on short-term outcomes and caregiver burden remains less studied. Here, we studied the prevalence of sleep dysfunction and its relationship with self-reported depression, caregiver burden, and functional outcome after stroke.

Methods: Prospective observational study where consecutive patients with acute ischemic stroke were recruited at 3 months follow-up visit from stroke outpatient clinic from January 2022-March 2023. After informed consent, all the recruited patients were administered 5 questionnaires[Epworth Sleepiness Scale, Insomnia Severity Index, and Pittsburgh Sleep Quality Index for sleep, Patient Health Quality 9 for depression, and Zarit's Caregiver Burden Scale]. 20% of patients underwent overnight ambulatory level 3 polysomnography. Clinical and sleep characteristics were correlated with functional outcome and caregiver burden scores at 3 and 6 months follow-up.

Results: Of 100 patients, with a mean age of 62.2 ± 11.2 years, 67% had moderate to severe strokes at admission with mean National Institute of Health Stroke Scale [NIHSS] 8.3 ± 6.24.63% reporting one or more sleep disturbances post-stroke. 20% had hypersomnolence,35% had insomnia and 40% had poor sleep quality at 3 months after stroke.45% reported depression and 22% caregivers reported significant burden. Caregiver burden had a strong correlation with patient-reported hypersomnolence and poor sleep quality. Sleep dysfunction showed a significant association with poor functional outcomes at 6 months after stroke.

Conclusion: Sleep dysfunction is present in a significant number of ischemic stroke survivors 3 months after stroke and can contribute to poor functional outcomes and caregiver stress. The impact of early recognition and timely treatment of sleep dysfunction post-stroke needs to be studied in larger populations.