Sleep-Wake Disorders in Stroke—Increased Stroke Risk and Deteriorated Recovery? An Evaluation on the Necessity for Prevention and Treatment

Abstract

Several studies have demonstrated that sleep-disordered breathing (SDB) is an independent risk factor for stroke and has a detrimental effect on stroke recovery. Short and long sleep duration and possibly other SWD (e.g., insomnia, circadian rhythm disorders) may also increase the risk of stroke and influence its outcome. Data on SDB treatment increasingly indicate a benefit on stroke risk and evolution while treatment of other SWD is still limited. A systematic search for SWD in stroke patients is justified due to their high frequency and their negative impact on stroke outcomes. Clinicians should actively consider available treatment options.

Incidence and prevalence of post-stroke insomnia: A systematic review and meta-analysis

“…A number of reviews have explored the impact of sleep disorders including insomnia as a risk factor for stroke [15,16], or the role of sleep in recovery following stroke [17]. However, no published systematic reviews of the prevalence or incidence of insomnia post-stroke exist.…”

Sleep Disorders in Stroke: An Update on Management

“…It seems to reduce insomnia effectively after stroke. However, the long-term physical and mental benefits do not seem to be apparent and need to be addressed with larger samples in the future [30,31].…”

“…The results from one case report showed that symptoms were relieved by clonazepam in 2 patients with RBD after stroke [30]. Doses of clonazepam ranging from 0.25-2.0 mg were reported to be effective for treating stroke patients with RBD [21,30]. In addition to clonazepam, melatonin can decrease violent attacks and improve dream enactment.…”

The Instant Spontaneous Neuronal Activity Modulation of Transcutaneous Auricular Vagus Nerve Stimulation on Patients With Primary Insomnia

“…Long-term insomnia not only disfunctions the neuroendocrine-immune interactions, but also contributes to complications such as anxiety, depression and hypertension. Currently available treatments are far from satisfactory because of their low efficacy and side effects (Duss et al, 2018). Furthermore, the underlying neural mechanisms and hereditary factors are poorly understood.…”