Evolution of sleep and sleep EEG after hemispheric stroke

Abstract

SUMMARY The evolution of subjective sleep and sleep electroencephalogram (EEG) after hemispheric stroke have been rarely studied and the relationship of sleep variables to stroke outcome is essentially unknown. We studied 27 patients with first hemispheric ischaemic stroke and no sleep apnoea in the acute (1–8 days), subacute (9–35 days), and chronic phase (5–24 months) after stroke. Clinical assessment included estimated sleep time per 24 h (EST) and Epworth sleepiness score (ESS) before stroke, as well as EST, ESS and clinical outcome after stroke. Sleep EEG data from stroke patients were compared with data from 11 hospitalized controls and published norms. Changes in EST (>2 h, 38% of patients) and ESS (>3 points, 26%) were frequent but correlated poorly with sleep EEG changes. In the chronic phase no significant differences in sleep EEG between controls and patients were found. High sleep efficiency and low wakefulness after sleep onset in the acute phase were associated with a good long‐term outcome. These two sleep EEG variables improved significantly from the acute to the subacute and chronic phase. In conclusion, hemispheric strokes can cause insomnia, hypersomnia or changes in sleep needs but only rarely persisting sleep EEG abnormalities. High sleep EEG continuity in the acute phase of stroke heralds a good clinical outcome.

Time to wake-up: Sleep problems and daytime sleepiness in long-term stroke survivors

“…We found that nocturnal sleep quality was generally poorer and daytime sleepiness was higher in patients with a first-time stroke between one and 15 years ago. This supports the assumption that sleep problems, frequently observed in the acute phase post stroke, may indeed evolve into a chronic problem in some individuals [10,12,13]. These results should be interpreted with caution due to the preliminary nature of the study.…”

“…It also revealed that it is unclear to what extent the sleep problems reported in the early phase after a stroke are transient. Some authors suggest that post-stroke sleep disturbances actually persist and become a chronic condition [10][11][12][13], but the evidence-base for this claim is poor and the prognosis beyond one-year post injury is not well understood. This is partly due to the use of heterogeneous study groups comprised of patients in various stages of recovery and with various levels of functional ability.…”

“…Drawing on a convenience sample of 20 younger stroke Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). The ESS is a valid and reliable measure of daytime sleepiness [16][17][18] and has been successfully used with traumatic brain injury and stroke patients [9,10,13,19,20]. It measures daytime sleepiness using eight items on a four-point-likert-scale ranging between 0-6 for low sleepiness, 7-9 for average sleepiness and 10-24 for severe sleepiness.…”

Sex differences in sleep: impact of biological sex and sex steroids

“…One prevailing theory with strong supportive evidence is that sleep serves a restorative function for the brain and body. Chronic insufficient sleep is a risk factor for a variety of psychological [9][10][11][12][13], neurological [14][15][16][17][18][19] and neurodegenerative pathologies [16], as well as cardiovascular and metabolic dysfunctions [20][21][22][23][24]. More recent findings from clinical studies reveal that women suffering from sleep disturbances and insufficient sleep are at greater risk compared with men for mood disorders such as depression [25], as well as metabolic [26] and cardiovascular dysfunction [23,[27][28][29].…”

Recording of bioelectrical activity changes in sheep cerebral cortex

“…The contrasting role is undoubtedly played by the amount of electroencephalographic literature regarding that kind of examination in humans. Most of the technical aspects, such as electrodes localization, research apparatus used and ranges of particular brain waves are widely known and successfully used in practice (Lesser et al 1985, Butler 1987, Homan et al 1987, Rosenblatt et al 1999, Vock et al 2002, Danko et al 2002, Armitage et al 2003, Velis 2005. Despite the many different opinions of researchers, it is certain that the electroencephalographic diagnostic is regarded highly among neurophysiological examinations and may be successfully used, not only in humans but in animals as well.…”