Stroke in sleep symptoms
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Stroke in Sleep Symptoms
Excessive Daytime Sleepiness (EDS) in Stroke Survivors
Excessive daytime sleepiness (EDS) is a common symptom among stroke survivors and is considered an independent risk factor for stroke. EDS can significantly reduce the quality of life, cognitive functioning, and daytime performance of stroke survivors. Factors contributing to EDS include sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS are generally negative, emphasizing the need for effective measurement and management strategies in clinical practice.
Sleep Disorders as Risk Factors and Consequences of Stroke
Sleep disorders are increasingly recognized as both risk factors for stroke and consequences of stroke. Common sleep disorders associated with stroke include sleep-disordered breathing (SDB), periodic limb movements during sleep, narcolepsy, REM sleep behavior disorder, insomnia, and circadian rhythm sleep-wake disorders. These disorders not only increase the risk of stroke but also worsen stroke outcomes, highlighting the importance of screening and treating sleep disorders in stroke patients.
Sleep Patterns and Acute Stroke Risk
Sleep disturbances, such as short sleep duration (<5 hours), long sleep duration (>9 hours), impaired sleep quality, difficulty in falling or staying asleep, unplanned napping, prolonged napping, snoring, snorting, and breathing cessation, are significantly associated with an increased risk of acute stroke. These symptoms may serve as markers of increased individual risk or independent risk factors for stroke, suggesting that addressing sleep disturbances could be crucial in stroke prevention.
Sleep-Disordered Breathing (SDB) and Stroke
More than half of stroke patients experience sleep-disordered breathing (SDB), primarily in the form of obstructive sleep apnea (OSA). SDB is both a risk factor and a consequence of stroke, and its presence is linked to poorer long-term outcomes and increased stroke mortality. Continuous positive airway pressure (CPAP) is the recommended treatment for OSA, which may improve stroke outcomes and reduce the risk of recurrence .
Functional Recovery and Sleep Health Parameters
Post-stroke sleep disturbances, including alterations in sleep architecture, OSA, restless legs syndrome, daytime sleepiness, and insomnia, can impact functional recovery. Studies have shown that poorer sleep health is associated with worse functional outcomes at three months post-stroke. CPAP treatment for severe OSA may offer benefits, although further research is needed to confirm its efficacy in improving functional recovery.
Insomnia and Stroke
Insomnia and insomnia symptoms are prevalent among stroke survivors, with a meta-analysis indicating a pooled prevalence of 38.2%. Insomnia is associated with comorbid conditions such as depression and anxiety, which can exacerbate sleep problems and negatively impact stroke recovery. Addressing insomnia through tailored interventions is essential for improving the overall well-being of stroke survivors.
Conclusion
Sleep disturbances are both significant risk factors for stroke and common consequences of stroke. Excessive daytime sleepiness, sleep-disordered breathing, insomnia, and other sleep-related issues can adversely affect stroke outcomes and recovery. Effective screening, diagnosis, and treatment of sleep disorders in stroke patients are crucial for improving their quality of life and reducing the risk of recurrent strokes. Future research should focus on the efficacy of sleep interventions in stroke prevention and recovery to develop comprehensive management strategies.
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