Researchers identify sleep as a problem in patients with stroke, and highlight the need to give greater consideration to sleep in stroke care, and in particular stroke rehabilitation.
• NICE guideline on stroke rehabilitation does not reference sleep at all
• Sleep essential for learning, mental and physical health
• Stroke care mainly focussed on daytime activity and ignores sleep altogether
Latest findings from the University of Surrey and University of Freiburg all point towards the important role of sleep in patients with stroke. However, at present, sleep is rarely considered in in-patient and community-based stroke care. The team of researchers also found that this is despite a number of studies that highlights patients with stroke often experience difficulties with their sleep.
Patients often report that going to sleep and staying asleep is difficult and aggravates the challenges of coping with everyday activities. But how much do we really know about the sleep of patients with chronic stroke and how their sleep compares to that of other older healthy people? For the first time, the researchers have addressed this question by drawing together all existing research comparing patients with stroke with control populations using polysomnography, the gold standard method to study sleep.
The study, published in the journal PLOS ONE, revealed that sleep is poor in stroke patients, but the research also highlighted the lack of knowledge in particular with regard to older people and chronic patients. For example, the team found no study comparing the sleep physiology of chronic stroke patients with other people in their respective age group. While there is some information on changes of sleep difficulties throughout stroke recovery, how stroke severity, lesion location, and sleep are linked to physical and mental health is generally unexplored.
"Sleep is essential for learning, mental and physical health in everybody but even more so for chronic stroke patients. A comprehensive and holistic understanding of sleep is therefore needed to improve rehabilitation effectiveness and ensure quality long term care," said lead author Professor Annette Sterr from the University of Surrey.
"However, this link between sleep and stroke has not yet entered clinical practice. The recent guideline for stroke rehabilitation issued by the UK National Institute for Health and Care Excellence (NICE) provides a detailed account of the medical, physical and psychological needs to be met through in-and outpatients stroke care, but these recommendations make no comment on sleep. Moreover, stroke care is focussed on daytime activity and ignores sleep altogether."
"In the UK, strokes are a major health problem. Every year, around 110,000 people have a stroke in England and it is the third largest cause of death. One key theme emerging through our research is the need to give greater consideration to sleep in stroke care, and in particular in stroke rehabilitation. By doing so this will ensure that each patient is treated fairly and an appropriate course of treatment is planned and implemented."
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