Sleep Quantity and Quality During Inpatient Rehabilitation After Stroke

ObjectiveTo identify sleep patterns and their association with recovery after stroke during inpatient rehabilitation, and to determine if clinical outcomes are different between participants demonstrating abnormal sleep patterns as compared to those with normal sleep patterns. MethodsCohort study in which participants were undergoing inpatient rehabilitation after a stroke. Sleep quantity and quality was measured using an actigraph that participants wore for up to 7 nights during the first week of inpatient rehabilitation. Medicare Quality Indicators (GG code), Barthel Index, gait speed, and Berg balance scale were collected at admission and discharge. Participants were categorized into groups based on meeting or not meeting recommended sleep quantity and quality guidelines. Association between sleep patterns and outcomes were assessed using Pearson correlation and differences in outcomes and length of stay between participants who met or did not meet sleep quantity and quality guidelines were determined using independent sample t-test. Results69 participants were in the study. Sleep quantity and quality was poor for all the participants. None of the participants met all the sleep quantity and quality guidelines. There were moderate to small associations (-0.42 to 0.22) between some sleep quantity and quality parameters and clinical outcomes. Participants whos sleep efficiency (SE) was <85% had a significantly longer length of stay compared to those whos SE was >=85% (17.4 vs. 21.5 days, p<0.05). ConclusionsPeople with stroke undergoing inpatient rehabilitation have poor sleep quantity and quality. There is a small to moderate association between sleep patterns and clinical outcomes and participants with poor sleep quality had longer length of stay compared to those with good sleep quality. Further research is necessary to better understand the complex relationship between sleep and recovery after stroke. ImpactSleep is associated with functional recovery during inpatient rehabilitation after stroke.