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Insomnia is likely to be a long-term side effect of stroke

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Stroke patients experience sustained problems with insomnia potentially reducing their ability to relearn key skills and putting them at increased risk of depression, according to researchers.

In the first study of its kind, researchers compared the brain signals of stroke patients and the general population.

“Harnessing the power of good sleep is likely to maximise recovery and quality of life”

Annette Sterr

Difficulties with sleeping in those who had a stroke have previously been reported but little is known about the brain signals underlying the problem, particularly in the community, said the team from the University of Surrey, the University of Freiburg in Germany, and the University of Bern in Switzerland.

They said it was also unclear how sleeping poorly during the night related to sleepiness and fatigue during the day. Using a polysomnogram test, which assessed brain sleeping patterns over two nights, the researchers found that it took stroke patients longer to fall asleep.

They were also found to have poorer sleep efficiency – the ratio of time spent asleep comparted to the time spent in bed – than those who had not experienced a stroke.

In addition, a multiple sleep latency test showed that stroke patients were less likely to nap or fall asleep during the day to compensate for lost sleep at night.

They were, however, more prone to errors in a vigilance test than their counterparts, increasing their risk of cognitive failures or falls, noted the researchers.

Importantly, although sleep efficiency was reduced in patients, total sleep time between the groups was similar, they said in the journal Scientific Reports.

“The importance of sleep in aiding the recovery of patients should not be underestimated”

Annette Sterr

This trend suggested that lesions in the brains’ centres for sleep-wake regulation were unlikely to cause the insomnia, the authors said.

Rather, they said the finding indicated that sleep problems experienced by stroke patients were due to a number of contributory factors, such as greater psychological strain, pain and discomfort as well as reduced levels of physical activity.

Professor Annette Sterr, from the University of Surrey, said: “Our research shows that those who have suffered from stroke maintain difficulties with their sleep which is likely to affect the overall recovery and quality of life.

“The importance of sleep in aiding the recovery of patients should not be underestimated in helping to improve and maintain physical and mental wellbeing,” said Professor Sterr.

“Presently sleep is not considered in National Institute for Health and Care Excellence guidelines for stroke rehabilitation, an issue we hope will be revisited by the organisation in due course,” she said.

“Harnessing the power of good sleep is likely to maximise recovery and quality of life,” she added.

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