Sleep Quality Poststroke Tied to Stroke Type, Brain Location, and Country Income

Stroke survivors commonly experience poor sleep quality, which in turn is related to stroke type, stroke location in the brain, and countries income. These are the findings of a study published in the journal Sleep Medicine Reviews.

Poor sleep quality is common among stroke survivors, but previous prevalence studies demonstrated mixed results. Further, a meta-analysis on poor sleep quality prevalence among stroke survivors does not exist as of the date of this research paper.

To address this gap, researchers performed a meta-analysis to evaluate the prevalence and risk factors for poor sleep quality among stroke survivors.

Using a systematic review, the researchers completed a literature search. The researchers included a total of 68 cross-sectional studies, consisting of 14,845 stroke survivors assessed with the Pittsburgh Sleep Quality Index (PSQI). These studies had a sample size that ranged from 31 to 1200 stroke survivors, and the participants had a mean age range of 34.38 to 76.11 years.

The prevalence of poor sleep quality in stroke survivors was 50.26% (95% CI, 46.69-53.82%).

In a subgroup analysis, the association was significant between country income and poor sleep quality prevalence (P <.001), with the lower middle-income countries having the highest prevalence of 77.91% (95% CI, 66.49-89.33%).

In a meta-regression analysis, the researchers found that stroke location in the left hemisphere of the brain had a negative association with poor sleep quality (P =.0495). However, the stroke type, such as a cerebral infarction, had a positive association with poor sleep quality (P =.0040).

Study limitations included reliance on self-reported measures, presence of study heterogeneity, limited data availability on certain important factors, and possible publication bias.

“In conclusion, poor sleep quality was found to be common among stroke patients in this meta-analysis, particularly in studies conducted in lower-middle-income countries,” the researchers concluded. “The location of stroke in the left hemisphere had a less effect on sleep quality while cerebral infarction had a greater effect on sleep quality.”