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Relationship between sleep disorder and subjective feelings of recovery in convalescent stroke patients

Koeda S, Sumigawa K, Koike Y, Sato C, Imai H, Osanai E, Shimizu T, Muto Y, Harigae A, Mizunashi A, Osanai T. Relationship between sleep disorder and subjective feelings of recovery in convalescent stroke patients. Jpn J Compr Rehabil Sci 2014; 5: 125-130. Objective: Sleep disorder occurs at a high frequency in stroke patients and can disrupt the progress of rehabilitation. Here, we investigated stroke patients’ recognition of their improvement (i.e. their subjective feelings of recovery). We also explored ways of preventing and treating sleep disorder in these stroke patients by determining the relationship between subjective feelings of recovery and sleep disorder. Methods: The study subjects were 42 patients who had been hospitalized in a kaifukuki (convalescent) rehabilitation ward for stroke. Subjects were scored on a Visual Analog Scale (VAS) for subjective feelings of recovery and on the Pittsburgh Sleep Quality Index (PSQI) as an indicator of sleep disorder. Results: A significant negative correlation was found in the relationship between subjective feelings of recovery and PSQI score. PSQI scores in the group with Low subjective feelings of recovery (VAS < 35%) were significantly higher than those in the group with High subjective feelings of recovery (VAS ≥ 35%). Sleep disorder in the former group was severe. Subjective feelings of recovery were significantly positively correlated with the stage of recovery from motor paralysis and with Activities of Daily Living (ADL) ability. However, the PSQI score was not correlated with either of these latter two measures. Conclusions: We speculated that a decrease in subjective feelings of recovery caused by motor paralysis and a decline in ADL abilities in patients with VAS scores lower than 35% led to impairment of the sleep state. These results suggest that evaluation of subjective feelings of recovery is an effective predictor of sleep disorder in stroke patients.