Poor Sleep Quality I Related to Impaired Functional Status Following Stroke

Introduction: Sleep disorders are more prevalent in patients with previous stroke compared to healthy individuals. The main objective of the present study was to investigate the impact of sleep quality on the functional status of patients with a history of stroke, upon admission to inpatient rehabilitation. Methods: Fifty patients (mean age: 69 +/- 11 years) with previous stroke were consecutively included in this single center cross-sectional observational study upon admission to inpatient rehabilitation. Pittsburgh Sleep Questionnaire Index (PSQI) was calculated for all patients and patients were divided into 2 groups according to PSQI scores (PSQI <= 5 as good sleepers and PSQI > 5 as poor sleepers). A specialist evaluated the level of muscle spasticity and disability, walking capability, and overall performance of daily activity of all enrolled patients using the functional ambulation scale (FAS) score, modified Brunnstrom Classification, Modified Ashworth scale, and Beck Depression Inventory. Results: The FAS score (3.4 +/- 1.3 versus 1.8 +/- 1.7, P = .004) and Brunnstrom scores of upper limb (3.8 +/- 1.1 versus 2.5 +/- 1.6, P = .005), lower limb (4.3 +/- 1.4 versus 3.1 +/- 1.7, P = .013) and hand (3.6 +/- 1.5 versus 2.3 +/- 1.6, P = .006) were significantly higher in good sleepers than poor sleepers. Linear regression analysis revealed that PSQI score (coefficient beta = -.360, 95% CI: -.212-.032, P = .009) and age (coefficient beta = -.291, 95% CI: .100-.245, P = .032) were independently associated with FAS score. Conclusion: Results of the present study indicate that presence of poor sleep quality is associated with poor functional status which might further impair the outcomes of the rehabilitation and accordingly the health-related quality of life in patients admitted for stroke rehabilitation.