A new study published May 30, 2018, in Scientific Reports, has discovered that insomnia (inability to fall asleep or remain asleep) may be a long-term effect after having experienced a stroke, especially in patients with right hemispheric stroke. This insomnia can interfere with a patient’s rehabilitation therapy and keep them from learning new skills. It can also lead to depression.
The researchers carried out their study in a sleep lab in the Department of Psychiatry and Psychotherapy at the University of Freiburg Medical Center in Germany on 22 people living in the community, who were one year after having had a stroke. They used a nocturnal polysomnogram (PSG) test to compare results of the stroke survivors with the general population and they also used a Multiple Sleep Latency Test. The researchers tested them for two nights although they did not analyze results from the first night. The participants in the study also kept a sleep diary.
The researchers discovered that those who had previously suffered a stroke took longer to fall asleep and slept fewer hours than the total hours that they spent in bed. Also, they did not fall asleep easily during the day to make up for the lost hours at night and they had difficulties with performing certain tasks. These conditions point to insomnia.
The researchers hope that checking for sleep disorders like insomnia will be taken more into consideration during stroke rehabilitation.
A study in Neurology Clinical Practice from June, 2013, showed that sleep breathing disorders like obstructive sleep apnea (OSA) are a high risk, but treatable factor for strokes and recurrent strokes. Also, OSA can interfere with recovery and rehabilitation following a stroke. Obstructive Sleep Apnea occurs in 20% of the population and aging and obesity increase the risk for OSA. In obstructive sleep apnea, people literally stop breathing periodically during sleep, which can lead to choking. This can happen hundreds of times during the night. This causes less oxygen to reach the brain. In fact some research has also shown a high association between OSA and the onset of Alzheimer’s disease, which may mean that OSA is a possible risk factor also for dementia.
OSA is also highly linked with other cardiovascular diseases like hypertension (high blood pressure), atrial fibrillation (abnormal heart beat), heart failure and diabetes.
OSA can be treated by continuous positive airway pressure (CPAP) and this not only lowers the risk for a further stroke, but also has a positive effect on regaining function after a stroke. Stroke is a major cause of disability in the US so it is imperative to find and treat sleep disorders that can hamper stroke rehabilitation.
The risk factors for strokes do not commonly also list obstructive sleep apnea. (OSA).
They are as follows:
Since sleep disorders are very common, but can be treated, it is imperative for stroke survivors to be tested for them in a sleep lab, which can detect sleeping disorders like insomnia and obstructive sleep apnea, both of which can interfere with stroke rehabilitation. Also, untreated obstructive sleep apnea can lead to another stroke. If your loved one has suffered a stroke inquire how to take them to a sleep lab or if they can be tested while still in the hospital or in a rehabilitation nursing facility.
Treating Insomnia and obstructive sleep apnea can lead to more effective stroke rehabilitation and also prevent a new stroke from happening
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