Sleep problems worsen health-related quality of life and participation during the first 12 months of stroke rehabilitation

Clin Rehabil. 2020 Nov;34(11):1400-1408. doi: 10.1177/0269215520935940. Epub 2020 Jun 30.


Objective: Evaluate the impact of self-reported sleep problems on post-stroke recovery.

Design: Cross-sectional secondary analysis of longitudinal data from the Locomotor Experience Applied Post-Stroke (LEAPS) rehabilitation and recovery study (phase-III single-blind randomized controlled clinical trial). Group medians were compared for three sleep problem groups across three time points.

Setting: Outpatient and in-home physical therapy.

Subjects: Adults during the first year following stroke (n = 408, 380, 360 at 2, 6, 12 months, respectively).

Interventions: The original study compared effects of locomotor training with body weight support in the year post-stroke. This analysis evaluated function in three sleep/functional-impact groups: no sleep problems, sleep problems with no-to-minimal-impact and sleep problems with moderate-to-quite-a-bit of impact.

Main measures: Participants' responses regarding if they had "a sleep problem, such as insomnia" and, if so, what the impact was on their function. Stroke Impact Scale subscales for strength, hand function, mobility, ADLs, memory, communication, emotion, participation, and percent recovery.

Results: About 25% of people with stroke reported sleep difficulty, 10% perceived sleep problems negatively impact function. Groups self-reporting worse sleep performed worse in all functional subscales (except self-perceived percent recovery) during the first year post-stroke.

Conclusion: Self-reported poor sleep adversely effects post-stroke functional recovery.

Keywords: Sleep wake disorders; physical therapy modalities; rehabilitation; stroke.

MeSH terms

  • Activities of Daily Living*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Sleep Wake Disorders / etiology*
  • Stroke / complications*
  • Stroke Rehabilitation*