Dados do Trabalho

Título

Sleep abnormalities in stroke: A case report

Introdução

Sleep disorders are highly prevalent in stroke patients, compromising their functional outcome and quality of life.

Objetivo

To describe the systematic evaluation and management of sleep disturbances in a post-stroke patient during his in-patient multidisciplinary rehabilitation program.

Métodos

A 56-year male patient suffered the first episode of a nucleocapsular ischemic stroke on 06/22/2023. He presented with hypertension, dyslipidemia and type 2 diabetes. During the in-patient rehabilitation, he underwent a systematic sleep assessment including: Epworth daytime sleepiness (EDS) Pittsburgh scales and objective sleep rhythm measurements provided by a wrist actigraphy (ActTrust2™, Condor Instruments, Brazil) for 13 days. Daily sessions of personalized sleep hygiene was delivered by the nursing team to establish regular sleep, reduce naps during week. Shoulder pain was controlled by the medical team.

Resultados

EDS (7/24) and Pittsburg (8/21) scales did not reveal sleep disturbances. Actigraphy assessment demonstrated a dysregulated sleep pattern, characterized by 4/5 episodes of daytime naps of ± 50 minutes during the day, in addition to frequent awakenings and an average total sleep time (TST) of 7h55min. After interventions, actigraphy measures demonstrated a standardization of bedtime and wake-up times, a reduction in daytime naps, increased TST to 8h43min, and fewer awakenings. No difference was observed in sleep onset latency. Objective sleep measures alerted the patient to keep the sleep hygiene protocol, even after hospital discharge.

Conclusões

Objective sleep abnormalities obtained by an actigraphy could guide a personalized sleep hygiene intervention. Self-report scales did not capture sleep disturbances in this stroke patient.

Palavras -chave

sleep; stroke; sleep hygiene; actigraphy