Actigraphic Analysis of the Sleep–Wake Cycle and Physical Activity Level in Patients with Stroke: Implications for Clinical Practice

Abstract

Several structures of the central nervous system are essential in the sleep-wake regulation process. This study aimed to identify which actigraphic parameters of the sleep-wake cycle (SWC) are compromised after stroke and determine whether low-level physical activity can influence the expression of sleep-cycle temporal variation, in order to discuss the implications for the clinical practice of patient rehabilitation. The study assessed 22 patients (55 ± 12 years) and 24 healthy individuals (57 ± 11 years), of both sexes. The instruments used were the International Physical Activity Questionnaire (IPAQ) and Actigraphy. Data were analyzed by the student t, Mann-Whitney, and Spearman's correlation tests. Patients' activity level was about 28% lower than that of healthy subjects. Furthermore, we recorded around 10% more activity in the sleep phase compared to the controls, indicating that patients suffer from fragmented sleep (p < .001). According to IPAQ classification, we observed that healthy individuals were classified more predominantly as active (66.7%) and patients as irregularly active B (72.8%). A significant correlation was found between IPAQ and total activity (R= -.25; p= .007) and sleep latency (R= .27; p= .0006). In conclusion, the results obtained show a decrease in activity intensity in the SWC and significant sleep alterations related to greater duration, latency, and fragmentation. It is suggested that, in addition to motor impairments, sleep disorder complaints should be given priority during clinical diagnosis of patients with stroke.

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