Study Objectives People with stroke are susceptible to developing sleep disorders, which may negatively impact recovery. Little is known about sleep health (SH) broadly and its impact on recovery after stroke. The purpose of this study was to explore factors that are associated with SH during recovery after stroke.
Methods Data were collected from 90 participants at 10-, 60-, and 90-days post stroke without moderate to severe obstructive sleep apnea. Sleep health was measured by combining data from actigraphy and self-report to create an SH score that reflected regularity, satisfaction, alertness, timing, efficiency, and duration of sleep. Factors that may be associated with SH that were collected were Patient Health Questionnaire 9 (PHQ-9), Montreal Cognitive Assessment (MOCA), Barthel Index (BI), gait speed (GS), oxygen desaturation index (ODI), age, and sex. A cumulative link mixed model (CLMM) was used to determine the association between SH and the independent factors.
Results The CLMM found that the PHQ-9 had a significant negative estimate of-0.116 (p = 0.0002) and that the BI had a significant estimate of 0.016 (p = 0.044). Indicating that higher depressive symptoms and lower functional ability are associated with poorer SH. Time post stroke was not associated with SH
Discussion We identified depression and functional ability as significant determinants of SH. Participants exhibited poor SH while in the hospital and it remained unchanged at 60 and 90 days after stroke. Further evaluation of the likely bidirectional relationship between depression/functional impairment and SH after stroke may lead to targets to improve stroke recovery and SH.
Competing Interest StatementThis work was supported by the National Institutes of Health NINR, Award Number R01NR018979
Funding StatementThis study was funded by the National Institutes of Health NINR, Award Number R01NR018979
Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
IRB of WCG gave ethical approval for this work IRB of SUNY Upstate Medical University gave ethical approval for this work IRB of University of Kansas gave ethical approval for this work IRB of Emory University gave ethical approval for this work
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FootnotesAll authors have read and approved this manuscript.
The authors have no conflicts of interest related to this manuscript.
Funding Support: This work was supported by the National Institutes of Health NINR, Award Number R01NR018979
Data AvailabilityData are not available for this study at the present time.
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