Management of Frequent Sleep Problem after Stroke

Sungju Jee; Hyunkyu Jeon

doi:10.12786/bn.2016.9.1.20

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Jee and Jeon: Management of Frequent Sleep Problem after Stroke

Review Article

Brain & Neurorehabilitation 2016; 9(1): 20-24.

Published online: 31 March 2016

DOI: https://doi.org/10.12786/bn.2016.9.1.20

Management of Frequent Sleep Problem after Stroke

Sungju Jee, M.D., Ph.D., Hyunkyu Jeon, M.D.

Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Korea.

Correspondence to: Sungju Jee, Department of Rehabilitation Medicine, Chungnam National University School of Medicine, 266, Munhwaro, Jung-gu, Daejeon 35015, Korea. Tel: 042-338-2423, Fax: 042-256-6056, drjeesungju@hanmail.net

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sleep related breathing disorders comprises disorders related abnormal pattern and status of the gas exchange during sleep. It has been reported that abnormal sleep pattern could results in an autonomic dysfunction during sleep and ends up to increase possibility to induce stroke and cardiovascular disease associated with atherosclerosis. Stroke is a disorder, which could cause death and critical disability in the adulthood. Sleep related breathing disorders and stroke has causal relationship in each other, which could influence on recovery to each other. Systematic evaluation and management for sleep disorder after stroke might have clinical importance. This review will comprise of topics about sleep related disorders in stroke patients including epidemiology, relationship between stroke and sleep disorder, diagnosis, and management of frequent sleep disorder.

Keywords: sleep wake disorder, sleep apnea syndrome, stroke, rehabilitation, therapy

Figures and Tables

Table 1

Diagnostics and Treatment of Sleep-Related Breathing and Sleep-Wake Disorders Following Stroke

Sleep-wake disorder	Diagnosis	Avoid/use with caution	Treatment	Level of evidence/recommendation
Obstructive sleep apnea	History, respirography (polysomnography)	Alcohol, hypnotic, sedative, antidepressant	CPAP	IV, U
Obstructive sleep apnea	History, respirography (polysomnography)	Alcohol, hypnotic, sedative, antidepressant	Weight loss, preference of lateral to supine sleeping position	IV, U
Disturbance of wakefulness (hypersomnia, EDS, fatigue)	History, questionnaires (actigraphy, polysomnography, vigilance tests)	Alcohol, hypnotics, sedatives, antidepressant	Stimulating antidepressant, Stimulants	IV, U
			Stimulating antidepressant, Stimulants	IV, U
			Levodopa	IV, U
Insomnia	History, questionnaires (actigraphy, polysomnography, vigilance tests)	Alcohol, caffeine, stimulating antidepressant	Zolpidem, Zopiclone	IV, U
			Sedative antidepressants	IV, U
			Non-pharmacologic sleep hygiene	IV, U

Recommendations were made based on the American Academy of Neurology classification of recommendation. Only studies in stroke patients were considered for these recommendations. EDS: excessive daytime sleepiness, CPAP: continuous positive airway pressure, BiPAP: biphasic positive airway pressure.

Notes

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (No. NRF-2015-R1C1A1A01055923).

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