Dados do Trabalho

Título

Post-Stroke Sleep Disorders

Introdução

Stroke is rare in young patients, making it essential to investigate factors that may justify its occurrence, including those related to apparently normal sleep patterns, since young people tend to pay less attention to sleep care.

Objetivo

Assessment of sleep patterns with the aim of identifying possible pre-stroke clinical changes, such as arrhythmias, obstructive apneas, and changes in the coagulation cascade, which may directly influence the patient's nighttime rest.

Métodos

A 24-year-old male patient presented with rhyme deviation, cognitive and speech changes on 12/02/2023, after an exhausting day of work and a family argument. His family members referred him to the emergency room, where he remained under observation for approximately nine days. His medical history included heart surgery in 2016 to correct an anomalous communication between the heart chambers. During rehabilitation, their Basic Human Needs were assessed, including sleep assessment using the Epworth Daytime Sleepiness Scale (EDS), the Pittsburgh Sleep Quality Scale, and monitoring with an actigraphy watch (ActTrust2™, Condor Instruments, Brazil) to analyze sleep rhythm and quantitative data. Then, guidance on "Sleep Hygiene" was provided, with daily monitoring by the nursing team, aiming to improve sleep patterns and contribute to their motor and physical rehabilitation.

Resultados

The Epworth Daytime Sleepiness (EDS) (10/24) and Pittsburgh Sleep Quality (5/21) scales did not indicate significant sleep disorders in the initial assessment, but suggested the presence of moderate daytime sleepiness. The actigraphy analysis, performed after the implementation of the "Sleep Hygiene" practices, revealed a regular sleep pattern, characterized by the absence of naps during the day and an average total sleep time (TTS) of 8 hours. The guidance for sleep hygiene included fundamental strategies, such as maintaining a consistent sleep routine, going to bed and waking up at the same time every day, which contributes to the regulation of the circadian cycle.

Conclusões

Although actigraphy data demonstrated high sleep efficiency, with an average of 90%, the patient still reported the sensation of not having effective rest. This discrepancy may be related to perceptual changes common in post-stroke patients. In addition, actigraphy revealed significant movements during sleep, suggesting the need for further investigations, such as polysomnography, to assess the presence of possible apnea episodes.

Palavras -chave

sleep assessment, apnea, stroke, actigraphy.