The impact of short and long sleep duration on instrumental activities of daily living among stroke survivors

Abstract

ObjectiveStroke survivors generally have problems completing instrumental activities of daily living (IADL; eg, preparing meals, chores, taking a bath, and managing finances). However, it is unclear how stroke survivors might stave off IADL issues. Studies indicating that sleep has restorative neurological effects provide potential mechanisms to address issues with IADL. The aim of this study was to ascertain the association between sleep duration (short or long sleep duration) and IADL among stroke survivors and those without a stroke history.MethodsData of 486,619 participants were analyzed from the 2000 to 2015 National Health Interview Survey (NHIS), a nationally representative sample. Measures of self-reported stroke, sociodemographic variables, sleep duration, and IADL problems were collected. Binary logistic regression was utilized to analyze the relationship of short (≤6 hours) and long (≥9 hours) sleep duration with limitations to IADL.ResultsOf the sample, 3% reported a physician-diagnosed stroke event. The mean age was 45.73 years; 52.7% were female; 77.4% were White; 14.2% were Black; 41.3% were married, 62.7% were employed; 31.1% reported that annual family income was less than $35,000; 87% reported good-to-excellent health; and 29.7% reported short sleep (≤6 hours). Approximately 30% of stroke survivors reported IADL problems, and 34.4% who reported IADL problems were short sleepers. Among stroke survivors, long sleepers were 97% more likely than average sleepers to report IADL problems (OR =1.97, 95% CI =1.71–2.26, P<0.001) adjusting for age, sex, race, marital status, poverty, and health.ConclusionFindings from our study indicate that, among stroke survivors, long sleepers were more likely to report IADL problems compared to average sleepers (7–8 hours). Future studies should investigate other potential mediators such as severity of stroke, medication, comorbidities, level of impairment, and whether improving sleep among stroke survivors may improve IADL.

Mental health according to sleep duration in stroke survivors: A population‐based nationwide cross‐sectional study

“…Sleep duration has been shown to be closely associated with poor functional outcomes and neurocognitive dysfunction in stroke survivors. In addition, sleep has a restorative neurological effect as such, stroke survivors who have shorter sleep duration might be at higher risk of experiencing suicidal thoughts and further neurological impairment. Attention to stroke survivorsʼ sleep duration, as well as offering education and promoting the importance of adequate sleep, are important in preventing suicidal ideation in this population, and interventions and management measures to relieve symptoms that hinder sleep, as well as to improve sleep disorders, are required.…”

“…Sleep duration was measured based on participantsʼ self‐reported responses to the question, “How many hours do you usually sleep a day?” The responses were classified into ≤5 h (short sleep), 6–8 h (moderate sleep) and ≥9 h (long sleep) …”

“…Older stroke patients have been found to show inappropriate sleep hygiene when they experience physical, environmental and emotional obstacles . Furthermore, short and long sleep duration among stroke survivors can be caused by insomnia and sleep apnea . Sleep duration has been shown to be closely associated with poor functional outcomes and neurocognitive dysfunction in stroke survivors .…”

“…Sleep duration has been shown to be closely associated with poor functional outcomes and neurocognitive dysfunction in stroke survivors . In addition, sleep has a restorative neurological effect, and proper sleep duration is important for independent daily living of stroke survivors . As sleep disorders can cause physical, emotional and behavioral disorders, and physiological instability in severe cases, appropriate sleep is crucial for everyone .…”

“…2 Previous studies have reported that many stroke survivors experience sleep disorders. [3][4][5] Older stroke patients have been found to show inappropriate sleep hygiene when they experience physical, environmental and emotional obstacles. 6 Furthermore, short and long sleep duration among stroke survivors can be caused by insomnia and sleep apnea.…”