1. This cross-sectional cohort study determined that there was an increased relative risk of sleep disturbances in adults who have previously suffered a stroke compared to those who have not. 

Evidence Rating Level: 2 (Good)

The experience of sleep disturbances for stroke patients is thought to be an important factor contributing to low mood, fatigue, impaired activities of daily living, and overall poorer post-stroke rehabilitation. Despite this, previous research has not adequately quantified the prevalence of sleep disturbances in this population. In this cross-sectional, population-based study, data was collected from the 2017-2018 Canadian Community Health Survey. 46,404 individuals were included in this study, 682 of whom reported a previous stroke. Four types of sleep disturbances were self-reported, including difficulty staying awake, abnormally short (<5 hr) or long (>9hr) sleep duration, difficulty falling or staying asleep, and lack of refreshing sleep. Authors adjusted for confounding variables, including diabetes status, age, sex, highest level of education, body mass index, physical activity level, and other self-reported chronic conditions. Relative risk was greater for all four types of sleep disturbances in the stroke group, with the greatest effect found on the ability to stay awake (RR 2.16, 95% confidence interval 1.59-2.94). It is important to note that this study does not define whether the increased prevalence of sleep disturbances in the stroke population existed prior to stroke occurrence; as such, no conclusions regarding causation can be made. Regardless, this study demonstrates an association between stroke and sleep disturbances and outlines the importance of screening for sleep issues in this patient population. Future research in this field may determine whether impaired sleep is more significant as a risk factor or result of stroke, as well as the extent to which impaired sleep impacts stroke rehabilitation.

Click to read the study in CMAJ

Image: PD

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